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OtherEvidence-Based Clinical Practice

Colonoscopy in Rural Communities: Can Family Physicians Perform the Procedure with Safe and Efficacious Results?

Jeffrey K. Edwards and Thomas E. Norris
The Journal of the American Board of Family Practice September 2004, 17 (5) 353-358; DOI: https://doi.org/10.3122/jabfm.17.5.353
Jeffrey K. Edwards
MD
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Thomas E. Norris
MD
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    Figure 1.

    Standardized data collection form.

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    Table 1.

    Estimated Number of Colonoscopies and the Total Years Physicians Had Been Performing Colonoscopy before Beginning the Study

    PhysicianNumber of CasesYears Performing Procedure
    A<503
    B50 to 1008
    C100 to 20012
    D>50015
    • View popup
    Table 2.

    Most Common Indications for 200 Colonoscopies (Some Cases Had Multiple Indications)

    IndicationNumber of CasesPercentage of Cases
    Rectal bleeding5226
    Hx of polyps4925
    FHx of colon cancer4422
    Stools positive for FOBT3518
    • Hx, history; FHx, family history; FOBT, fecal occult blood testing.

    • View popup
    Table 3.

    Rate to Reach the Cecum

    PhysicianNumber of ColonoscopiesTimes Cecum ReachedPercentage
    A232191
    B454396
    C2424100
    D10810597
    Total20019396.5
    • View popup
    Table 4.

    Average Time to Cecum and Procedure Completion by Physician

    PhysicianAverage Time to Reach Cecum (minutes)Average Time to Complete Procedure (minutes)
    A23.851.1
    B16.636.5
    C16.933.7
    D6.516.3
    Average15.934.4
    • View popup
    Table 5.

    Frequency of Neoplastic Polyps Based on Most Common Procedure Indications

    IndicationNumber of Cases (Total)Percentage of Cases
    Stools positive for FOBT9 (35)26
    Hx of polyps13 (49)27
    FHx of colon cancer8 (44)18
    Rectal bleeding11 (52)21
    • Hx, history; FHx, family history; FOBT, fecal occult blood testing.

    • View popup
    Table 6.

    Review of Reported Rates of Reaching the Cecum More Than 90% of the Time

    AuthorYearnRate to Cecum (%)
    Marshall et al4199341896
    Church1519942,90793.6
    Marshall and Barthel5199542393.4
    Hopper et al12199671393
    Chak et al1199631594.3
    Pierzchajlo et al11199775191.5
    Wexner et al1619982,06996.5
    Tassios et al17199943091
    Kim et al21200090996.4
    Wexner et al18200113,58092
    Anderson et al22200175591.6
    Thomas-Gibson et al10200250593
    Nelson et al620023,19697
    Current study200420096.5
    • View popup
    Table 7.

    Review of Reported Time to Reach the Cecum

    AuthorYearnMean Time to Cecum (minutes)
    Marshall51995349*
    Chak et al1199629710.5*
    Kim et al2120009096.9
    Anderson et al2220017555.6*
    Nelson et al62002319610.5
    Current study200420015.9
    • * Median rather than mean.

    • View popup
    Table 8.

    Review of Reported Time to Complete Colonoscopy

    AuthorYearnMean Time to Completion (minutes)
    Wexner et al1619981,02334.7
    Wexner et al18200113,58022.7
    Nelson et al620023,19630.6
    Current study200420034.4
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The Journal of the American Board of Family Practice: 17 (5)
The Journal of the American Board of Family Practice
Vol. 17, Issue 5
1 Sep 2004
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Colonoscopy in Rural Communities: Can Family Physicians Perform the Procedure with Safe and Efficacious Results?
Jeffrey K. Edwards, Thomas E. Norris
The Journal of the American Board of Family Practice Sep 2004, 17 (5) 353-358; DOI: 10.3122/jabfm.17.5.353

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Colonoscopy in Rural Communities: Can Family Physicians Perform the Procedure with Safe and Efficacious Results?
Jeffrey K. Edwards, Thomas E. Norris
The Journal of the American Board of Family Practice Sep 2004, 17 (5) 353-358; DOI: 10.3122/jabfm.17.5.353
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