A Gastroenterologist is a specialist in gastrointestinal diseases and has received special training in colonoscopy. Gastroenterologists perform more colonoscopies by far than any other specialty. Non-gastroenterologists are five times more likely to miss colorectal cancer during colonoscopy than Gastroenterologists 1.
Proper training in colonoscopy is necessary not only to increase the chance that the procedure can be completed and any necessary treatments applied, but also to be sure that abnormal results can be properly interpreted. The American Society for Gastrointestinal Endoscopy recommends that persons performing colonoscopy complete a fellowship program in gastroenterology or receive training in colonoscopy during a surgical residency.
Many Gastroenterologists have performed many thousands of colonoscopies. A colonoscopist should know the rate at which their procedures have been associated with a perforation or making a hole in the colon. This rate should certainly be below 1 in 500 examinations and many experts have rates of perforation well below 1 in 1000.
Experienced colonoscopists reach the very beginning of the large intestine (the cecum) in more than 90% of cases and in more than 95% of patients who are undergoing screening. Screening is the process of checking people who have no symptoms for colon polyps and cancer.
Persons performing colonoscopy must be trained in the removal of polyps. Although even Gastroenterologists may refer a patient with a large polyp to a special expert in the removal of polyps, a trained colonoscopist can remove the overwhelming majority of routine polyps.
1 Rex DK, Rahmani E, Haseman JH, et al. Relative sensitivity of colonoscopy and barium enema