ASCs are seeing a surge in colonoscopy demand as CRC rates rise, especially among adults under 50.
Updated screening guidelines that lowered the recommended starting age from 50 to 45 have added millions of newly eligible patients, driving a steady increase in screening volume. Practices report noticeable jumps in patient inquiries and referrals since the guideline change.
Omar Khokhar, MD, a gastroenterologist at Illinois GastroHealth in Bloomington, told Becker’s that colonoscopy demand in 2025 has been a “double-edged sword.”
“On one hand, volume stayed high — screening normalization post-pandemic plus aging demographics kept our calendars full,” he said. “On the other hand, that demand exposed our early choke points.”
With GI procedures accounting for 28.3% of all Medicare ASC volume, centers are moving beyond short-term capacity management toward long-range operational planning. Many ASCs are redesigning scheduling workflows, standardizing pre-procedure education and reevaluating anesthesia coverage models to support rising colonoscopy volume.
Dr. Khokhar and his team now view colonoscopy volume as a “demand signal,” rather than a burden, that pushes them to “modernize, automate, and scale.”
Some leaders are adopting new staffing models to provide more hands-on patient support. Benjamin Levy, MD, a gastroenterologist at the University of Chicago Medicine, told Becker’s that his team has expanded the use of nursing navigators for patients directly scheduled for colonoscopies by their primary care physicians.
“Nursing navigators are important to help patients with their prep, to answer questions and to standardize preoperative care,” he said. “The goal is to improve prep quality, to help patients on anticoagulation — coordinating with PCPs and subspecialists — and to prepare patients who might be on GLP-1 agonists for weight loss with careful instructions about when to hold their medication.”
AI may also become a key tool gastroenterologists use to manage growing colonoscopy demand.
“2025 will be an important year for the rollout of artificial intelligence in gastroenterology, including AI-assisted endoscopic tools to help us identify polyps during gastroenterology procedures,” Dr. Levy said. “Increasingly, gastroenterologists will use AI dictation software in clinic, which will help improve the accuracy of notes, decrease the amount of time we spend typing, lower the potential for repetitive stress wrist/hand injuries for endoscopists and hopefully allow gastroenterologists to increase the number of patients we can see in clinic each day.”
