Quality assessment is a priority in the field of gastroenterology. However, limited data are available from Greece regarding adherence to quality standards in gastrointestinal endoscopy. This study aims at assessing the knowledge and compliance of Greek gastroenterologists with established quality standards for upper and lower digestive endoscopy, while exploring factors that may influence compliance.

This prospective study recorded data on the quality of upper and lower digestive endoscopy performed in Greece from October 2024 to January 2025. All members of the Hellenic Society of Gastroenterology (n=668) were invited to participate via an electronic survey. The survey included a questionnaire designed specifically for this study, covering demographic and professional characteristics, as well as quality indicators for gastroscopy and colonoscopy.

A total of 164 gastroenterologists participated (response rate 24.55%), of whom 107(65.24%) were male, and 102(62.2%) working in public or academic hospitals. The duration of gastroscopy was not recorded by 116(70.73%) participants, while 102(62.2%) systematically used photodocumentation. Most participants utilized the Prague and Los Angeles classifications (156, 95.12% and 159, 96.95%, respectively). Additionally, 140(85.37%) followed the Seattle protocol, and 158 (96.34%) conducted biopsies according to ESGE guidelines for precancerous gastric lesions. However, 83(50.61%) don’t use a registry for patients with Barrett’s esophagus. Complications were systematically recorded after gastroscopy by 103(62.8%) and after colonoscopy by 90(54.88%).In colonoscopy, 149(90.85%) use the BBPS scale, and 158(96.34%) reported successful cecal intubation. Withdrawal times exceeded six minutes for 151(92.07%) participants. An adenoma detection rate of over 25% was achieved by 117(71.78%), while 103(62.8%) consistently used the Paris classification. Proper polypectomy techniques were employed by 111(67.68%), but 100(60.98%) recommended follow-up intervals shorter than guidelines suggest. Patient experience following gastroscopy and colonoscopy was not recorded by 126(76.83%) and 116(70.73%) participants, respectively. Overall, compliance with quality indicators for upper and lower digestive endoscopy was observed in 87(53.05%) and 75(45.73%) participants, respectively. Multivariate analysis revealed that greater experience (p=0,05), the use of video recording (p=0,01), and use of high-resolution endoscopes (p<0,01) were associated with improved compliance.

In this study, discrepancies were observed in the compliance of Greek endoscopists with endoscopic quality indicators, highlighting the need for further improvement. The systematic recording of these quality indicators is essential, highlighting  the important role of scientific societies in this process.