How many endoscopies are performed for colorectal cancer screening? Results from CDC's survey of endoscopic capacity

Background & Aims: Estimates of the current number of endoscopic colorectal cancer screening and follow-up examinations being performed are limited. A national study was therefore conducted among US physician practices. Methods: Approximately 1800 medical practices were surveyed from a list of all practices known to have purchased or leased lower endoscopic equipment between 1996 and 2000. Questions were asked regarding the current number of lower endoscopic procedures performed and the potential maximum number that could be performed. Results: In 2002, a total of 8207 practices reported performing flexible sigmoidoscopy or colonoscopy in the United States. Gastroenterologists performed 43.7% (95% confidence interval [CI], 37.2-50.2) of all sigmoidoscopies and 82.5% (95% CI, 80.3-84.7) of all colonoscopies. Primary care physicians performed 24.9% (95% CI, 20.3-29.5) of all sigmoidoscopies and 2.0% (95% CI, 1.4-2.6) of all colonoscopies. All physicians combined performed approximately 2.8 million (95% CI, 2.4-3.1) flexible sigmoidoscopies and 14.2 million (95% CI, 12.1-16.4) colonoscopies but reported that they could increase to approximately 9.5 million flexible sigmoidoscopies (95% CI, 8.4-10.5) and 22.4 million colonoscopies (95% CI, 20.1-24.8) in 1 year. Conclusions: Approximately 2.8 million flexible sigmoidoscopies and 14.2 million colonoscopies were estimated to have been performed in 2002. Physicians reported that they could perform an additional 6.7 million flexible sigmoidoscopies and 8.2 million colonoscopies in 1 year. These additional procedures could be used for the unscreened population and should be considered in the estimate of the national capacity to provide colorectal cancer screening to all eligible persons in the United States.