Primary-care physicians can fill gap in colorectal cancer screening

Jan 12, 2009
Primary-care physicians can fill gap in colorectal cancer screening
The number of people who need colonoscopies to screen for colorectal cancer is outpacing the number of endoscopists available to perform them, Medical College of Georgia researchers say. But properly trained primary care physicians -- internists, family medicine physicians, obstetricians and gynecologists and general practitioners -- can perform the test as safely and effectively as endoscopists, according to a study published in the Jan. 12 issue of the Annals of Family Medicine Credit: Phil Jones, Medical College of Georgia campus photographer

The number of people who need colonoscopies to screen for colorectal cancer is outpacing the number of endoscopists available to perform them, Medical College of Georgia researchers say.

A booming aging population has increased the number of people over 50, the age when the American Cancer Society recommends beginning regular screening for colorectal cancer, the third most common and second most fatal cancer in the United States.

"The key to changing that is catching the disease early through screening," says Dr. Thad Wilkins, a family medicine physician in the MCG School of Medicine. "With slightly more than 12,000 board-certified gastroenterologists, who perform endoscopy procedures like colonoscopies, the capacity for a national screening program is limited. Resources to screen every eligible person for colorectal cancer do not currently exist in the U.S. medical system and, as a result, less than one-third of those who are eligible for colonoscopies are screened."

Properly trained primary care physicians - internists, family medicine physicians, obstetricians and gynecologists and general practitioners - can perform the test as safely and effectively as endoscopists, according to a study published in the January 12 issue of the Annals of Family Medicine.

Dr. Wilkins and colleagues from the University of Virginia Health System and Lexington Medical Center in Lexington, S.C., analyzed 12 studies of 18,292 patients who had colonoscopies performed by a "trained and competent" primary care physician. To determine whether the tests were performed safely and effectively, they looked at the number of complications, such as tears caused by the scope and bleeding problems; the completeness of the test, as measured by whether the physician reached the cecum, or end of the colon; and the polyp and cancer detection rates. Polyps are extra tissue inside the colon that can potentially indicate or turn into cancer.

"In our study we found a very low complication rate - only three cases of perforation and four cases of bleeding complications," he added. The analysis also reflected a nearly 90 percent reach-the-cecum rate, and a polyp-detection rate of nearly 29 percent.

"Each of these outcomes are comparable to published results by other specialists," Dr. Wilkins says. "The take-home point is that colonoscopies performed by trained and competent primary care physicians can be just as safe and effective as those performed by other endoscopists."

The U.S. Preventive Services Task Force and other recognized groups have recommended colonoscopies as a suitable and, perhaps, the most cost-effective screening methods for colorectal cancers.

"Therefore the demand for colonoscopy will continue to grow," Dr. Wilkins says. "Primary care physicians can help meet that demand."

Source: Medical College of Georgia

Explore further: Cold cash just keeps washing in from ALS challenge

add to favorites email to friend print save as pdf

Related Stories

Functional genomics gets tiny

May 17, 2012

A little more than a decade ago, researchers discovered an ancient mechanism that cells use to silence genes. Like a dimmer switch turning down a light, RNA interference (RNAi) dials down gene activity in ...

Recommended for you

Cold cash just keeps washing in from ALS challenge

Aug 28, 2014

In the couple of hours it took an official from the ALS Association to return a reporter's call for comment, the group's ubiquitous "ice bucket challenge" had brought in a few million more dollars.

Medtronic spends $350M on another European deal

Aug 27, 2014

U.S. medical device maker Medtronic is building stronger ties to Europe, a couple months after announcing a $42.9 billion acquisition that involves moving its main executive offices across the Atlantic, where it can get a ...

Mind over matter for people with disabilities

Aug 26, 2014

People with serious physical disabilities are unable to do the everyday things that most of us take for granted despite having the will – and the brainpower – to do so. This is changing thanks to European ...

Ukraine's former world's tallest man dies

Aug 25, 2014

Ukraine's tallest man, who briefly held the world record but gave it up to live as a recluse, has died due to complications from the condition that saw him never stop growing, local media reported Monday.

User comments : 0