Nearly 30% of outpatient colonoscopies for colon cancer screening or polyp surveillance were preceded by a gastroenterology office visit, with that number reaching a staggering 50.5% in the South, according to an analysis of 842,849 middle-aged adults.

Patients with a higher Charlson Comorbidity Index (CCI) also were more likely to have an office visit. Still, 66.4% of patients with an office visit had a CCI of 0.

“Although the precolonoscopy office visits added a modest $36 per colonoscopy in this population, there are an estimated 7 million screening colonoscopies performed in the United States annually, so the cumulative costs are significant,” reported Dr. Kevin Riggs of Johns Hopkins University, Baltimore, and associates reported (JAMA. 2016 Feb 2. doi:10.1001/jama2015.15278 ).

The cost of precolonoscopy office visits has received little attention despite scrutiny of the high cost of colonoscopy in the United States and the availability of open-access colonoscopy since the 1990s, the authors noted.

The primary limitation of the study was the inability to determine the exact circumstances of the office visits. Patients with a diagnosis of colon cancer or inflammatory bowel disease in the prior 12 months were excluded from the analysis.

The study was funded by the National Institutes of Health and the National Cancer Institute. Dr. Riggs’ salary is supported by an NIH grant. Coauthor and colleague Dr. Craig Pollack reported stock ownership in the Advisory Board Company and that his salary is supported by a grant from the NCI.


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