Americans get too many colonoscopies, study says

Colonoscopy is the gold standard for colorectal cancer screening and prevention, but new research suggests that current screening practices may be leading to an overuse of the procedure.

The study, published in the Journal of General Internal Medicine, examines whether or not existing screening guidelines are being followed. National guidelines recommend that adults 50 years or older should be screened every 10 years, and screened more often in the case that adenomas are found.

The researchers analyzed EHR data of 1,429 adults who underwent colonoscopy for CRC screening between 2001 and 2010. Of these cases, 871 subsequent exams were performed. Researchers found:

•    88 percent of the follow-up screening colonoscopies were done earlier than recommended by the guidelines.
•    49 percent of surveillance colonoscopies were done earlier than recommended by the guidelines.
•    Patients with no signs of polyps during the first screening had a subsequent examine an average of 6.9 years later.
•    Patients with benign polyps were underwent a second colonoscopy an average of 5.9 years later.

Based on these findings, researchers concluded that patients aged 50 to 74 who are enrolled in a screening program receive one additional colonoscopy in their lifetime compared to what is recommended. Though there are a larger number of unnecessary screening colonoscopies performed each year, one in four exams that find precancerous polyps are not followed up on within the appropriate interval.

"The overused colonoscopies on the patients in this study along represent a potential excess of over $1 million in healthcare spending – resources that might benefit those who are overdue for colon cancer screening," said study author Gina Kruse, MD, according to the report.

The researchers recommend that providers carefully monitor follow-up recommendations as a way to potentially reduce unnecessary colonoscopies.

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9 gastroenterologists in the news

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