Work

Risk factors for inadequate bowel preparation and quality improvement strategies in colonoscopy: a narrative review

Year: 2026

Type: review

Abstract: Colonoscopy is the gold-standard screening test for colorectal cancer, yet its diagnostic yield relies heavily on adequate bowel preparation. Despite standard protocols, 20%-30% of procedures still have inadequate cleansing, which lowers adenoma detection, prolongs procedures, increases repeat examinations, and wastes resources. Preparation quality is influenced by multiple interacting factors: patient characteristics (age, comorbidities, medication use, adherence), regimen features (purgative type, dose, split-dose scheduling), and healthcare delivery (education quality, appointment timing). Most previous studies have examined these factors in isolation, leaving a gap in integrated, evidence-based guidance. This narrative review synthesizes current knowledge on determinants of preparation quality, with emphasis on emerging strategies such as risk-stratified protocols, low-volume purgatives, digital health tools (mobile apps, SMS reminders), and AI-based real-time assessment. We aim to provide a practical framework for individualized preparation, thereby improving both the efficiency and quality of colonoscopy-based screening.

Source: Frontiers in Surgery

DOI: 10.3389/fsurg.2026.1969199

Authors: Shanshan Ma, Xinyu Zhou

Institution: Sun Yat-sen University Cancer Center

Language: English

Topic: Colorectal Cancer Screening and Detection

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801