Concerns are mounting that the introduction of the national colonoscopy screening program will lead to a surge in doctors' “lawsuits, arrests, and bankruptcies” due to complications if there is no legal protection against medical disputes.

On Monday, the Ministry of Health and Welfare and the National Cancer Center held the “Colonoscopy Pilot Project Symposium.”

At the workshop, the medical community expressed concerns about the planned introduction of the national colonoscopy screening, saying that legal liability cannot be avoided in the event of complications after a colonoscopy.

“We all know that colonoscopy is important for colon cancer screening. We almost don’t need other tests,” said Dr. Park Soo-heon, president of the Korean Society of Gastrointestinal Endoscopy. “Given the high risk of colonoscopy, however, many doctors will become ex-convicts (due to the introduction of national colonoscopy screening).”

Park noted that many “black consumers” are among Korean patients today. To introduce a national colonoscopy program, there should be a way to avoid legal penalties related to post-test complications and compensation that considers such compensation, he added.

Lee Eun-jung, head of the Colonoscopy Research Group of the Korean Society of Coloproctology, agreed.

“I support the introduction of a national colonoscopy screening program, but we need to consider compensation and treatment for complications following colonoscopies,” Lee said.

Kim Young-sun, an advisor to the Korean Society of Gastrointestinal Endoscopy who has been involved in the pilot project since its inception, also expressed concern.

“The pilot project results were excellent, but we need to think about why the results were good,” Kim said. “In the pilot project, the qualification of the colonoscopy doctor and thorough quality control, including observation for more than six minutes after the procedure, were the main reasons for the good results.”

Kim pointed out that colonoscopies are an option now. Still, when they become a mainstream business, they will be a patient's right, emphasizing that the medical community should prepare more soberly for quality control.

Kim added that if the medical community doesn't manage quality, it won't be able to address various concerns such as legal issues, stressing that ”if we don't manage quality, it could harm the public.”

“The medical community is experiencing an increase in judicial risks (related to medical accidents), with lawsuits, prosecutions, and conviction rates all on the rise,” Kim said. “If doctors are told to perform (colonoscopies) unconditionally without (legal) protection, some may go bankrupt due to high legal fees.”

Officials from the Ministry of Health and Welfare said the ministry would start the project by looking for quality control and legal protection measures.

“If it is to be introduced as a national cancer screening program, we need to look at the age cycle, feasibility, affordability, and efficiency as important measures,” said Yoo Bo-young, head of the Disease Policy Division. “We will review and analyze in detail how to start the program based on the pilot project results and make a proposal for the main project.”

Yoo continued, “Strengthening legal protection for complications following colonoscopies is essential. It is one of the government's four major healthcare reform program tasks. We will take care not to miss this aspect.”

Director Yoo added that once the national colonoscopy screening program is implemented, the government will establish criteria for selecting screening centers for quality control.

“Quality control is crucial. One of the reasons why the results of the pilot project were good was because the screening centers were well selected,” Yoo said. “We will consider attaching conditions or establishing standards for screening centers (when the national colonoscopy program is introduced).”

Yoo continued, “In addition to this, our division will consult with the Health Insurance Policy Bureau regarding the number of procedures and surgeries that occur after colonoscopy so that we can introduce it without any unreasonable parts, such as trying not to lose money for medical institutions.”

At the symposium, Seo Min-ah, head of the Cancer Screening Division at the National Cancer Center, presented the results of the “'Colonoscopy Pilot Project” conducted from 2019 to 2024.

The pilot project's total number of colonoscopies was 26,004, and the screenings by type were 9,743 (37.47 percent) at general hospitals, 6,191 (23.81 percent) at hospitals, and 10,070 (38.72 percent) at clinics.

By age, 7,451 (28.65 percent) of the checkups were for people aged 50 to 54, followed by 6,069 (23.34 percent) for people aged 60 to 64, 5,558 (21.37 percent) for people aged 55 to 59, 4,069 (15.65 percent) for people aged 65 to 69, and 2,857 (10.99 percent) for people aged 70 to 74.

According to the results of the “Minor Complication Survey,” to which 24,339 people responded out of 26,004 screenings, 220 people (0.90 percent) had abdominal pain for more than two hours after the screening, and 44 people (0.18 percent) had bleeding of more than one spoonful after the screening.

According to the detection rate by pilot project participant characteristics, out of 24,929 respondents, 15,422 (61.86 percent) were polyps, with an expected polyp detection rate of 40-60 percent; 11,044 (44.30 percent) were adenomas, with an expected adenoma detection rate of 7.4-52.5 percent; and 140 (0.56 percent) were cancers, with an expected cancer detection rate of about 0.5 percent.