Patient's choice in colonoscopy specialist may impact the detection of bowel cancer (colon cancer)

Background & Aims:

Data confirms that the incidence of colorectal cancer (CRC) is reduced for at least 10 years after a negative colonoscopy, compared with the general population. However, CRCs do occur in individuals after a negative colonoscopy. 

This article investigated whether the colonoscopy volume and specialty of the endoscopists who perform the exam are associated with CRC after a negative complete colonoscopy. 

Methods:

Canadian residents in Ontario aged 50-80 years old, who had a negative complete colonoscopy between 1992 - 1997, was identified by using linked administrative databases. Cohort members had no history of colon cancer.  Each individual with a new diagnosis bowel cancer were identified.

Over 110,000 individuals with a negative complete colonoscopy were identified. During the 15-year follow-up period, 1596 patients (1.5%) developed CRC. Although there was no association between endoscopist colonoscopy volume and incidence of bowel cancer, there was a significant increase in the risk of developing colon cancer if their procedures was NOT performed by a gastroenterologist.

Conclusions

The specialty of the endoscopist who performs your colonoscopy is an important determinant of the effectiveness of colonoscopy in clinical practice.

Clin Gastroenterology Hepatol 2010 Mar: 8;275