Outpatient Colonoscopy by Rural Family Physicians

Article Figures & Data

Table 1.

Indications for Colonoscopy and Adenomatous Polyp Yield by Indication (N = 731)

Indication*	% (No.)	With Adenomas^†% (No.)
* Some patients had more than 1 indication.
† Villous adenomas and adenomatous polyps are considered together as adenomas.
‡ The relatively low percentage of screening studies is attributed to Medicare coverage for screening colonoscopy not occurring until 2000, late in the case series.
Previous polyps	22.2 (229)	32.3 (74)
Rectal bleeding	19.8 (204)	16.7 (34)
Family history of	10.5 (108)	18.5 (20)
colon cancer
Abdominal pain	10.0 (103)	15.5 (16)
Screening^‡	9.3 (96)	17.7 (17)
Heme-positive stool	6.5 (67)	25.4 (17)
Iron deficiency	4.2 (43)	14.0 (6)
Constipation	3.9 (40)	15.0 (6)
Change in bowel habits	3.8 (39)	25.6 (10)
Chronic diarrhea	2.7 (28)	17.9 (5)
Weight loss	0.3 (3)	0.0 (0)
Other	6.2 (64)	—
Nonspecified	0.7 (7)	—

Table 2.

Distribution of Adenomas Detected (N = 731)

Location	Number	Percent
Note: Adenomas include both adenomatous polyps and villous adenomas. Only 24% of patients with adenomas proximal to the splenic flexure also had concurrent polyps in the descending colon or below.
Cecum	24	10.1
Ascending colon	50	21.0
Hepatic flexure	14	5.9
Transverse colon	45	18.9
Splenic flexure	5	2.1
Descending colon	24	10.1
Sigmoid colon	38	16.0
Rectosigmoid junction	5	2.1
Rectum	33	13.8
Totals	238	100.0

Supplemental Appendixes

Supplemental Appendix 1.Yield of pathologic findings in 731 colonoscopies. Supplemental Appendix 2. Adenoma yield by age and sex (N = 731 Cases). Supplemental Appendix 3. Patients referred for colorectal surgery.

Files in this Data Supplement:

Supplemental data: Appendix 1 - PDF file, 1 page, 54 KB
Supplemental data: Appendix 2 - PDF file, 1 page, 56 KB
Supplemental data: Appendix 3 - PDF file, 1 page, 65 KB
The Article in Brief

Colorectal cancer is the second leading cause of cancer deaths in the United States. Colonoscopy�a test that allows a doctor to look at the interior lining of the large intestine�can help detect colorectal cancer. Only a small percentage of eligible patients receive colonoscopies, however, in part because there are not enough medical professionals trained to conduct the procedure. This study found that colonoscopies can be performed safely and competently by properly trained family physicians in the outpatient setting. The study examined data from 2 family physicians performing colonoscopies. The physicians met or exceeded all of the target goals for high-quality colonoscopy examinations. Patients who had an office colonoscopy reported high levels of satisfaction with the procedure.