LOW-COST, OFFICE-BASED, SCREENING COLONOSCOPY

Citation
Jd. Rogge et al., LOW-COST, OFFICE-BASED, SCREENING COLONOSCOPY, The American journal of gastroenterology, 89(10), 1994, pp. 1775-1780
Citations number
38
Categorie Soggetti
Gastroenterology & Hepatology
ISSN journal
00029270
Volume
89
Issue
10
Year of publication
1994
Pages
1775 - 1780
Database
ISI
SICI code
0002-9270(1994)89:10<1775:LOSC>2.0.ZU;2-R
Abstract
Objectives: Performing full colonoscopy at regular intervals and remov ing lesions at an early stage might significantly lower the incidence and mortality of colorectal cancer. Such a program must be inexpensive , safe, and time-efficient. Methods: Screening colonoscopy was perform ed on 639 patients. For a normal examination, the physician's time is limited to giving the medication for conscious sedation, performing th e colonoscopy, and completing a written report form. The total charge for a normal screening colonoscopy is $150. Results: Adenomatous and/o r hyperplastic polyps were detected in 218 patients (34.1%). One hundr ed sixty adenomatous and 134 hyperplastic polyps were removed. Forty-e ight percent (48.1%) of the adenomatous and 21.6% of the hyperplastic polyps were above the sigmoid colon. Six adenocarcinomas were detected in five patients. One patient had a delayed bleeding episode requirin g no transfusion or therapeutic intervention, and one patient had a '' post-polypectomy syndrome'' requiring no therapeutic intervention. The average physician time in the endoscopy room for normal examinations was 18 min. Conclusions: Screening colonoscopy can be safely performed in an office facility. Physician time with the patient should be limi ted to allow a low cost that compares favorably with screening costs f or other malignancies. Long-term studies to assess the capability of s creening colonoscopy to lower mortality from colorectal cancer should continue.