Gastroenterology

Gastroenterology

Volume 127, Issue 6, December 2004, Pages 1670-1677
Gastroenterology

Rapid communications
How many endoscopies are performed for colorectal cancer screening? Results from CDC’s survey of endoscopic capacity

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Background & Aims: Estimates of the current number of endoscopic colorectal cancer screening and follow-up examinations being performed are limited. A national study was therefore conducted among US physician practices. Methods: Approximately 1800 medical practices were surveyed from a list of all practices known to have purchased or leased lower endoscopic equipment between 1996 and 2000. Questions were asked regarding the current number of lower endoscopic procedures performed and the potential maximum number that could be performed. Results: In 2002, a total of 8207 practices reported performing flexible sigmoidoscopy or colonoscopy in the United States. Gastroenterologists performed 43.7% (95% confidence interval [CI], 37.2–50.2) of all sigmoidoscopies and 82.5% (95% CI, 80.3–84.7) of all colonoscopies. Primary care physicians performed 24.9% (95% CI, 20.3–29.5) of all sigmoidoscopies and 2.0% (95% CI, 1.4–2.6) of all colonoscopies. All physicians combined performed approximately 2.8 million (95% CI, 2.4–3.1) flexible sigmoidoscopies and 14.2 million (95% CI, 12.1–16.4) colonoscopies but reported that they could increase to approximately 9.5 million flexible sigmoidoscopies (95% CI, 8.4–10.5) and 22.4 million colonoscopies (95% CI, 20.1–24.8) in 1 year. Conclusions: Approximately 2.8 million flexible sigmoidoscopies and 14.2 million colonoscopies were estimated to have been performed in 2002. Physicians reported that they could perform an additional 6.7 million flexible sigmoidoscopies and 8.2 million colonoscopies in 1 year. These additional procedures could be used for the unscreened population and should be considered in the estimate of the national capacity to provide colorectal cancer screening to all eligible persons in the United States.

Section snippets

Sampling frame

The sampling frame included all US medical facilities known to have purchased or leased lower endoscopic (sigmoidoscopy and colonoscopy) equipment between January 1, 1996, and December 31, 2000. We obtained lists of these customers from the 4 leading US endoscopic equipment manufacturers: Fujinon Inc, Olympus America, Pentax Precision Instruments Inc, and Welch-Allyn. We also obtained a list of all single-specialty and multispecialty ambulatory endoscopy/surgery centers (AECs) in the United

Results

Survey respondents identified themselves as physicians (81.6%), nurses (5.7%), and “other” (12.7%), which included administrators. Responding physicians identified their practice specialties as gastroenterology (49.0%), internal medicine (21.5%), surgery (16.9%), and family or general practice (12.0%).

Surveys were classified by practice specialty according to the type of physicians performing the majority of endoscopic procedures (gastroenterology, primary care, surgery, or mixed). For mixed

Discussion

This report presents new information on the number of practices in the United States performing flexible sigmoidoscopy and colonoscopy, the physician specialists performing the procedures, and the current and potential volume of lower endoscopic procedures nationally and regionally.

Of all specialists who responded to our survey, gastroenterologists performed most of the flexible sigmoidoscopies and colonoscopies, although primary care physicians and surgeons performed a substantial proportion

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  • Cited by (0)

    1

    M.T.M.’s current affiliation is: National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.

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