NEW YORK, N.Y.—Researchers at Mount Sinai School of Medicine have found that 92 percent of more than 1,000 gastroenterologists responding to a survey believed that pressures to increase the volume of colonoscopies adversely impacted how they performed their procedures, which could potentially affect the quality of colon cancer screening.
The findings, based on responses from members of the American Society for Gastrointestinal Endoscopy (ASGE), are published in the March 2012 issue of Gastrointestinal Endoscopy.
“The number of colonoscopies has risen dramatically over the past 15 years, but it is imperative that an increase in volume not occur at the expense of quality and safety," said Lawrence B. Cohen, MD, lead study author and an associate clinical professor of gastroenterology at Mount Sinai. “Balancing quantity and quality is an issue that needs to be addressed in order to ensure the continued success of colon cancer prevention programs."
Overall, 92.3 percent of survey respondents indicated that production pressures, such as heightened demand for the procedure, rising overhead or shrinking reimbursement rates, resulted in physicians postponing, aborting or reducing the extent of a colonoscopy procedure.
For example, 7.2 percent of participants said production pressures made them reduce the time examining the colon wall, 5.3 percent of participants said these pressures made them abort a difficult colonoscopy, and 69 percent said they performed a colonoscopy on a patient with an unfavorable risk/benefit ratio.
Mount Sinai researchers sent a 40-question survey to the 5,739 members of the ASGE working in the United States and received 1,073 completed responses. The survey focused on three key areas: the respondent's demographic and practice characteristics, the operational characteristics of their facilities and their observations of colleagues.
Additional results of the survey include: