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Colonoscopy Reporting and Data System (CO-RADS)

Colonoscopy is being used more often for colorectal cancer screening, diagnosis, and therapy. Its effectiveness and safety depend on the quality of the examination. Evidence shows the quality of performance in clinical practice varies. In 2002, the U.S. Multi-Society Task Force on Colorectal Cancer published recommendations to improve the quality of colonoscopy, including indicators that should be measured by colonoscopy practices as part of ongoing quality improvement. An obstacle to measuring quality within and across practices has been the absence of a standardized reporting system for colonoscopy.


With the support and leadership of the Centers for Disease Control and Prevention, in partnership with the American Cancer Society, the Quality Assurance Task Group of the National Colorectal Cancer Roundtable developed the Colonoscopy Reporting and Data System (CO-RADS), a standardized colonoscopy reporting and data system.

CO-RADS specifies the elements that should be included in all colonoscopy reports and presents a standard method for reporting them. It also specifies the key indicators, such as percentage of exams with adequate bowel preparation, fecal intubation rate, and adenoma detection rate, which should be considered for periodic monitoring by every endoscopy unit in a program of continuous quality improvement. Routine measurement enables endoscopists to identify performance areas that can be improved.

Besides serving as a tool for endoscopists to facilitate quality improvement programs, CO-RADS should lead to improved communication with referring physicians and patients by providing reports that use standard terms and include specific recommendations for follow-up. Primary care providers can base referral decisions on performance on key quality indicators.

Key Endorsements

The governing boards of the American College of Gastroenterology, the American Gastroenterological Association Institute, and the American Society of Gastrointestinal Endoscopy have approved this standardized system.