Dr David Lieberman and colleagues assessed capacity for colonoscopy.
The research team needed to understand current utilization of colonoscopy in diverse clinical practice settings.
The researchers determined the utilization of colonoscopy in diverse clinical practice settings.
The Clinical Outcomes Research Initiative data repository was used, which receives endoscopy reports from 73 adult practice sites in the USA.
Colonoscopy reports from 2000 to 2002 were analyzed to determine the demographic characteristics of 146,457 adult patients.
The patients had received a colonoscopy and the procedure indication.
The relationship of age, race, gender, and procedure indication was analyzed.
Of the reports, 68% came from nonacademic settings.
Patients less than 50 years of age accounted for 20% of colonoscopies.
The team found that the most common indications were rectal bleeding in 34%, and irritable bowel symptoms in 24%.
|38% of colonoscopies were for asymptomatic screening in those over 50 years|
Screening because of a positive family history of colorectal cancer was also amongst the most common indications in 22%.
The researchers observed that screening with a primary colonoscopy or a fecal occult blood test was a common indication in 13%.
In patients 50 years and older, asymptomatic screening accounted for 38% of all colonoscopies.
The team noted that surveillance colonoscopy in patients with previous cancer or polyps accounted for 22% of colonoscopies performed in this age group.
Differences in utilization were noted, based on gender and race.
Dr Lieberman's team commented, “Colonoscopy utilization varies based on age, gender, and race.”
“Colonoscopy often is performed in patients less than 50 years old for irritable bowel symptoms, rectal bleeding, or average-risk screening, for which benefits are uncertain.”
“In patients older than 50 years, surveillance after polyp removal is a common indication and may be overused.”
“Understanding utilization can lead to further study to determine outcomes, to optimize utilization, and to provide a basis for shifting limited resources.”