This study performed a multifactorial carbon footprint assessment and sensitivity analysis of colonoscopy.

This was a 1-week, single-center, prospective study including all outpatient diagnostic colonoscopies (n = 66). A cradle-to-grave life-cycle assessment methodology evaluated all essential supplies (accessories #1–15), endoscopic procedure (energy consumption, carbon dioxide [CO2] insufflation, bowel preparation, sedation), staff and patient transport, and waste management. The impact assessment was based on sensitivity analysis in different scenarios (base, best, worst) to calculate the Global Warming Potential over 100 years (GWP-100 measured in kg of CO2 equivalent [kgCO2e]).

GWP-100 of a single colonoscopy was estimated to be 18.09 kgCO2e in the base scenario, with patient (8.61 kgCO2e) and staff (5.09 kgCO2e) transport, colonoscope manufacture and reprocessing (2.1 kgCO2e), and supplies (1.91 kgCO2e) contributing 47.6%, 28.1%, 11.7%, and 10.6%, respectively. Nitrile gloves, underpads, and a disposable peripheral oxygen saturation sensor accounted for nearly 50% of the total carbon footprint of all supplies. Patient preparation (bowel preparation, sedation, and CO2 insufflation) and energy consumption contributed only 2.0%. Staff and patient travel showed significant variations among worst, base, and best scenarios, with 18.8, 13.7, and 10.2 kgCO2e, respectively. The use of different amounts of medical supplies raised the carbon footprint to 2.38 kgCO2e in the worst scenario or diminished it to 1.56 kgCO2e in the best case.

This analysis and multifactorial colonoscopy procedure assessment confirmed patient and staff transport as the main carbon footprint contributors. More sustainable and smarter transport could considerably lower the environmental impact of colonoscopy.

Received: 11 March 2025

Accepted after revision: 27 August 2025

Accepted Manuscript online:
03 September 2025

Article published online:
10 October 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany