Delivering a high-quality colonoscopy service fit for the 21^st century

Colorectal cancer (CRC) is the third most prevalent cancer globally. There is a concerning increase in its incidence among younger individuals. Colonoscopy remains the gold standard for CRC diagnosis. With the introduction of population-based bowel screening and increased public awareness, there has been a significant rise in referrals for colonoscopy. Healthcare providers worldwide will need to strategically evaluate how to allocate resources to adequately train the next generation of colonoscopists who will need to provide accurate endoscopic assessment and treatment for premalignant polyps and early CRC. This review outlines the current workload challenges faced by colonoscopists whilst exploring emerging technologies such as artificial intelligence for adenoma detection. Additionally, advanced endoscopic surgical techniques like endoscopic submucosal dissection are discussed.