Capacity for Colorectal Cancer Screening by Colonoscopy, Montana, 2008

Background: Colorectal cancer is largely preventable by screening, but screening participation is low in Montana. Colonoscopy is often considered the most accurate screening test and has the potential to prevent colon cancer by pre-emptive removal of polyps. However, colonoscopy may not be equally available to all residents of rural states. The Montana Department of Public Health and Human Services (DPHHS) has assigned high priority to colorectal cancer prevention, but before beginning a campaign to increase screening, DPHHS conducted a Survey to determine existing colonoscopy screening capacity. Methods: An eight-question survey was sent by DPHHS to all hospitals and ambulatory surgical centers that perform colonoscopy in Montana, assessing their current and projected capacity to perform screening colonoscopies. Data were collected from March to May 2008, and analysis was performed in June 2008. Results: Responses were received from 43 of 44 hospitals and ambulatory surgical centers performing colonoscopies in Montana. The number of screening colonoscopies performed was estimated to be 19,444 per year. Unused colonoscopy screening capacity was estimated to be 23,096 procedures per year. Although similar total capacity existed in urban and rural areas, more unused capacity existed in rural areas. Conclusions: Montana has statewide capacity to meet moderately increased demand for screening colonoscopy but would be able to meet only 17% of demand in 2009 if all eligible adults chose colonoscopy as their primary form of screening. It is feasible to develop campaigns to increase screening colonoscopy participation now, but a systematic combination of colonoscopy and other screening modalities may be better able to meet Montana's long-term needs.