To meet the high demand for colonoscopy, the Veterans Health Administration often refers veterans to community practices. Petros et al. compared colonoscopy quality at a Veterans Affairs Medical Center with that of local community practices. Although community providers performed more timely colonoscopy than the Veterans Affairs medical center (mean 25 days earlier), colonoscopy quality was significantly lower for other important quality metrics, including adenoma detection, advanced adenoma detection, adenomas per colonoscopy, and appropriate surveillance recommendations. This study highlights the need for continued efforts to assure high-quality colonoscopy in all settings.
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