The views of gastroenterologists about the role of nurse endoscopists, especially in colorectal cancer screening


Dr P. G. van Putten, Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, Room Ba 393 A, 3015 GD, Rotterdam, The Netherlands.


Background  Nurse endoscopists may provide a solution for the insufficient endoscopic capacity in colorectal cancer (CRC) screening.

Aim  To determine the views of gastroenterologists about the potential role of nurse endoscopists in gastrointestinal endoscopy.

Methods  A postal questionnaire was sent to all registered gastroenterologists (n = 301) and gastroenterology residents (n = 79) in the Netherlands.

Results  Two hundred and thirty five of 380 (62%) gastroenterologists and residents completed the questionnaire. Overall, 48% were positive towards introduction of nurse endoscopists, whereas 18% were neutral and 34% negative. Respondents expected no major differences in endoscopic quality between physicians and nurse endoscopists. Nevertheless, 69% expected that patient experiences would be better met by physicians. Multivariate analysis showed that actual experience with nurse endoscopists and beliefs that nurse endoscopists are able to provide adequate endoscopic quality and good patient experiences, were independent predictors for a positive attitude towards introduction of nurse endoscopists [OR 6.6 (2.3–18.4), OR 1.9 (1.2–3.5) and OR 2.1 (1.2–2.9), respectively]. Respectively 89% and 66% of the respondents considered sigmoidoscopy and colonoscopy for CRC screening as appropriate procedures to be performed by nurse endoscopists. Diagnostic and therapeutic endoscopies were considered less appropriate.

Conclusion  A majority of gastroenterologists have a positive attitude towards introduction of nurse endoscopists, especially for CRC screening endoscopies.