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January 20, 2011

Primary care physicians could effectively help fill colonoscopist shortage, researcher says

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Primary care physicians can perform life-saving colonoscopies safely and effectively, according to an analysis published in the journal of the Annals of Family Medicine. Dr. Scott Strayer, associate professor in the Departments of Family Medicine and Public Health Sciences at the University of Virginia Health System and a lead investigator, now believes that primary care physicians can help fill the void left by insufficient numbers of colonoscopists.

“Some 90 million Americans are at risk for developing colorectal cancer with more than 50,000 dying from the disease each year,” said Strayer. “We wanted to learn whether primary care physicians could safely perform colonoscopies and contribute to helping more people beat this survivable cancer.”

Strayer and his team poured through 590 research articles and found 12 that reported on colonoscopies performed by primary care physicians. The number of patients studied in the articles totaled 18,292, half of whom were women. The average age was 59 years old.

The researchers found that detection rates for polyps and cancerous growths were 28.9 percent and 1.7 percent, respectively. The rate at which doctors reached the small bowel opening was 89.2 percent.  This rate improved to 90.5 percent when only procedures using sedation were included. The major complication rate was .04 percent, with only four patients having bleeding complications and three patients with colonic perforations (.02 percent). There were no deaths.

These safety and quality data are comparable to the recommendations issued by the American Society for Gastrointestinal Endoscopy, The American College of Gastroenterology and the Society of American Gastrointestinal Endoscopic Surgeons.

“Based on these results, we believe that colonoscopy screening by primary care physicians is a reasonable way to supplement the cadre of endoscopists who perform colonoscopies,” Strayer added.

Strayer collaborated with Dr. Thad Wilkins, associate professor of Family Medicine at the Medical College of Georgia, to conduct this study.

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