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Current Capacity for Endoscopic CRC Screening in the United States

Objectives: Little information is available on resources for delivery of endoscopic colorectal cancer (CRC) screening and follow-up diagnostic and surveillance procedures. This study examined data on endoscopic resources at the provider level.

Results: Approximately 65 percent of sigmoidoscopy procedures were performed by primary care physicians, 25 percent by gastroenterologists, and 10 percent by general surgeons. Only 30 percent of primary care physicians performed any procedures, and average volume among those who did was relatively low. Gastroenterologists performed two-thirds of all colonoscopy procedures, with most of the remainder performed by general surgeons.

Conclusions: There is potential to increase capacity to perform screening sigmoidoscopy procedures through primary care delivery. However, without careful consideration of organizational factors, this could result in increased cost and quality control problems. Increasing the capacity for screening colonoscopy is feasible, but will require attention to other problems, such as avoiding over-frequent (e.g., annual or biennial) procedures in low-risk patients.

Reference: Brown ML, Klabunde CN, Mysliwiec P. Current capacity for endoscopic colorectal cancer screening in the United States: data from the National Cancer Institute survey of Colorectal Cancer Screening Practices. Am J Med 2003;115:129-33. [View Abstract]

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Last Modified: 11 Apr 2014