Colonoscopy utilization in rural areas by general surgeons: An analysis of the National Ambulatory Medical Care Survey
One in three adults above 50 years old have not been screened for colorectal cancer as of 2013.1 Rural areas have even lower screening and have more general surgeons compared to gastroenterologists,2 offering surgeons as a reservoir for necessary services. Public data from the 2006–2015 CDC National...
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| Veröffentlicht in: | The American journal of surgery 2019-08, Vol.218 (2), p.281-287 |
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| creator | Komaravolu, Sreeya S. Kim, Julia J. Singh, Supreet Merchant, Aziz M. |
| description | One in three adults above 50 years old have not been screened for colorectal cancer as of 2013.1 Rural areas have even lower screening and have more general surgeons compared to gastroenterologists,2 offering surgeons as a reservoir for necessary services.
Public data from the 2006–2015 CDC National Ambulatory Medical Care Survey was analyzed using SAS. Number of colonoscopies performed by rural general surgeons, family medicine practitioners, and other specialties were compared to their urban counterparts.
21.91% of rural colonoscopies were performed by general surgeons, whereas 32.87% were performed by family medicine practitioners and 45.22% by other specialties including gastroenterologists. Rural general surgeons performed a greater percentage of annual rural colonoscopies than urban general surgeons (p |
| doi_str_mv | 10.1016/j.amjsurg.2019.02.009 |
| format | Article |
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Public data from the 2006–2015 CDC National Ambulatory Medical Care Survey was analyzed using SAS. Number of colonoscopies performed by rural general surgeons, family medicine practitioners, and other specialties were compared to their urban counterparts.
21.91% of rural colonoscopies were performed by general surgeons, whereas 32.87% were performed by family medicine practitioners and 45.22% by other specialties including gastroenterologists. Rural general surgeons performed a greater percentage of annual rural colonoscopies than urban general surgeons (p < 0.05).
General surgeons are fulfilling the need for colonoscopy in rural areas. Improvements to current colonoscopy training guidelines are imperative, especially for physicians who practice in rural areas.
Summary: Colonoscopies are the most sensitive and specific screening method for colorectal cancer, yet there is a deficit in screening in the United States that disproportionately affects patients in rural communities. Studies show that much of rural general surgery practice consists of endoscopic procedures. Using data recorded by the National Ambulatory Medical Care Survey (NAMCS), we found that rural general surgeons perform more colonoscopies than other rural providers, and a greater percentage of annual rural procedures than urban general surgeons. We conclude that general surgeons are filling the unmet need for colonoscopies in rural communities, therefore it is important to ensure surgery programs adequately train residents to confidently perform these procedures.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2019.02.009</identifier><identifier>PMID: 30791993</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Age ; Aged ; Bone surgery ; Burden ; Codes ; Colon ; Colonoscopy ; Colonoscopy - statistics & numerical data ; Colorectal cancer ; Colorectal carcinoma ; Confidence intervals ; Demographics ; Disease control ; Endoscopy ; Female ; Gastroenterology ; General Surgery ; Health care ; Health care access ; Health Care Surveys ; Humans ; Large intestine ; Male ; Medicaid ; Medical personnel ; Medical screening ; Medicare ; Medicine ; Middle Aged ; NAMCS ; Patients ; Physicians ; Polls & surveys ; Procedures and Techniques Utilization - statistics & numerical data ; Rural ; Rural areas ; Rural Health Services - statistics & numerical data ; Surgeons ; Surgical education ; Urban areas ; Young Adult</subject><ispartof>The American journal of surgery, 2019-08, Vol.218 (2), p.281-287</ispartof><rights>2019 Elsevier Inc.</rights><rights>Copyright © 2019 Elsevier Inc. All rights reserved.</rights><rights>2019. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-3b66697e72bb4b1d1dc23c52bdaab2cfab124494cd204a6f1fcfed712c36e5f93</citedby><cites>FETCH-LOGICAL-c393t-3b66697e72bb4b1d1dc23c52bdaab2cfab124494cd204a6f1fcfed712c36e5f93</cites><orcidid>0000-0001-8808-3653 ; 0000-0001-6464-2203</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2256593006?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30791993$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Komaravolu, Sreeya S.</creatorcontrib><creatorcontrib>Kim, Julia J.</creatorcontrib><creatorcontrib>Singh, Supreet</creatorcontrib><creatorcontrib>Merchant, Aziz M.</creatorcontrib><title>Colonoscopy utilization in rural areas by general surgeons: An analysis of the National Ambulatory Medical Care Survey</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>One in three adults above 50 years old have not been screened for colorectal cancer as of 2013.1 Rural areas have even lower screening and have more general surgeons compared to gastroenterologists,2 offering surgeons as a reservoir for necessary services.
Public data from the 2006–2015 CDC National Ambulatory Medical Care Survey was analyzed using SAS. Number of colonoscopies performed by rural general surgeons, family medicine practitioners, and other specialties were compared to their urban counterparts.
21.91% of rural colonoscopies were performed by general surgeons, whereas 32.87% were performed by family medicine practitioners and 45.22% by other specialties including gastroenterologists. Rural general surgeons performed a greater percentage of annual rural colonoscopies than urban general surgeons (p < 0.05).
General surgeons are fulfilling the need for colonoscopy in rural areas. Improvements to current colonoscopy training guidelines are imperative, especially for physicians who practice in rural areas.
Summary: Colonoscopies are the most sensitive and specific screening method for colorectal cancer, yet there is a deficit in screening in the United States that disproportionately affects patients in rural communities. Studies show that much of rural general surgery practice consists of endoscopic procedures. Using data recorded by the National Ambulatory Medical Care Survey (NAMCS), we found that rural general surgeons perform more colonoscopies than other rural providers, and a greater percentage of annual rural procedures than urban general surgeons. We conclude that general surgeons are filling the unmet need for colonoscopies in rural communities, therefore it is important to ensure surgery programs adequately train residents to confidently perform these procedures.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Bone surgery</subject><subject>Burden</subject><subject>Codes</subject><subject>Colon</subject><subject>Colonoscopy</subject><subject>Colonoscopy - statistics & numerical data</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Confidence intervals</subject><subject>Demographics</subject><subject>Disease control</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>General Surgery</subject><subject>Health care</subject><subject>Health care access</subject><subject>Health Care Surveys</subject><subject>Humans</subject><subject>Large intestine</subject><subject>Male</subject><subject>Medicaid</subject><subject>Medical personnel</subject><subject>Medical screening</subject><subject>Medicare</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>NAMCS</subject><subject>Patients</subject><subject>Physicians</subject><subject>Polls & surveys</subject><subject>Procedures and Techniques Utilization - statistics & numerical data</subject><subject>Rural</subject><subject>Rural areas</subject><subject>Rural Health Services - statistics & numerical data</subject><subject>Surgeons</subject><subject>Surgical education</subject><subject>Urban areas</subject><subject>Young Adult</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkU-P0zAQxS0EYrsLHwFkiQuXBI-dPzUXVFWwIC1wAM6W7UwWR0lc7LhS-PS4tHDgwmk0o997o5lHyDNgJTBoXg2lnoaYwn3JGciS8ZIx-YBsYNvKArZb8ZBsGGO8kA2wK3Id45BbgEo8JleCtRKkFBty3PvRzz5af1hpWtzofurF-Zm6mYYU9Eh1QB2pWek9znganJain-NrupupnvW4Rhep7-nyHemn3-pM7SaTRr34sNKP2DmbR_tsRb-kcMT1CXnU6zHi00u9Id_evf26f1_cfb79sN_dFVZIsRTCNE0jW2y5MZWBDjrLha256bQ23PbaAK8qWdmOs0o3PfS2x64FbkWDdS_FDXl59j0E_yNhXNTkosVx1DP6FBWHbV23UHHI6It_0MGnkE_JFK-bWgrGmkzVZ8oGH2PAXh2Cm3RYFTB1CkYN6hKMOgWjGFc5mKx7fnFPZsLur-pPEhl4cwYwv-PoMKhoHc42_y6gXVTn3X9W_AIivKON</recordid><startdate>201908</startdate><enddate>201908</enddate><creator>Komaravolu, Sreeya S.</creator><creator>Kim, Julia J.</creator><creator>Singh, Supreet</creator><creator>Merchant, Aziz M.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8808-3653</orcidid><orcidid>https://orcid.org/0000-0001-6464-2203</orcidid></search><sort><creationdate>201908</creationdate><title>Colonoscopy utilization in rural areas by general surgeons: An analysis of the National Ambulatory Medical Care Survey</title><author>Komaravolu, Sreeya S. ; Kim, Julia J. ; Singh, Supreet ; Merchant, Aziz M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-3b66697e72bb4b1d1dc23c52bdaab2cfab124494cd204a6f1fcfed712c36e5f93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Bone surgery</topic><topic>Burden</topic><topic>Codes</topic><topic>Colon</topic><topic>Colonoscopy</topic><topic>Colonoscopy - statistics & numerical data</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Confidence intervals</topic><topic>Demographics</topic><topic>Disease control</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>General Surgery</topic><topic>Health care</topic><topic>Health care access</topic><topic>Health Care Surveys</topic><topic>Humans</topic><topic>Large intestine</topic><topic>Male</topic><topic>Medicaid</topic><topic>Medical personnel</topic><topic>Medical screening</topic><topic>Medicare</topic><topic>Medicine</topic><topic>Middle Aged</topic><topic>NAMCS</topic><topic>Patients</topic><topic>Physicians</topic><topic>Polls & surveys</topic><topic>Procedures and Techniques Utilization - statistics & numerical data</topic><topic>Rural</topic><topic>Rural areas</topic><topic>Rural Health Services - statistics & numerical data</topic><topic>Surgeons</topic><topic>Surgical education</topic><topic>Urban areas</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Komaravolu, Sreeya S.</creatorcontrib><creatorcontrib>Kim, Julia J.</creatorcontrib><creatorcontrib>Singh, Supreet</creatorcontrib><creatorcontrib>Merchant, Aziz M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest research library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Komaravolu, Sreeya S.</au><au>Kim, Julia J.</au><au>Singh, Supreet</au><au>Merchant, Aziz M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Colonoscopy utilization in rural areas by general surgeons: An analysis of the National Ambulatory Medical Care Survey</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2019-08</date><risdate>2019</risdate><volume>218</volume><issue>2</issue><spage>281</spage><epage>287</epage><pages>281-287</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>One in three adults above 50 years old have not been screened for colorectal cancer as of 2013.1 Rural areas have even lower screening and have more general surgeons compared to gastroenterologists,2 offering surgeons as a reservoir for necessary services.
Public data from the 2006–2015 CDC National Ambulatory Medical Care Survey was analyzed using SAS. Number of colonoscopies performed by rural general surgeons, family medicine practitioners, and other specialties were compared to their urban counterparts.
21.91% of rural colonoscopies were performed by general surgeons, whereas 32.87% were performed by family medicine practitioners and 45.22% by other specialties including gastroenterologists. Rural general surgeons performed a greater percentage of annual rural colonoscopies than urban general surgeons (p < 0.05).
General surgeons are fulfilling the need for colonoscopy in rural areas. Improvements to current colonoscopy training guidelines are imperative, especially for physicians who practice in rural areas.
Summary: Colonoscopies are the most sensitive and specific screening method for colorectal cancer, yet there is a deficit in screening in the United States that disproportionately affects patients in rural communities. Studies show that much of rural general surgery practice consists of endoscopic procedures. Using data recorded by the National Ambulatory Medical Care Survey (NAMCS), we found that rural general surgeons perform more colonoscopies than other rural providers, and a greater percentage of annual rural procedures than urban general surgeons. We conclude that general surgeons are filling the unmet need for colonoscopies in rural communities, therefore it is important to ensure surgery programs adequately train residents to confidently perform these procedures.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30791993</pmid><doi>10.1016/j.amjsurg.2019.02.009</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-8808-3653</orcidid><orcidid>https://orcid.org/0000-0001-6464-2203</orcidid></addata></record> |
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| subjects | Adolescent Adult Age Aged Bone surgery Burden Codes Colon Colonoscopy Colonoscopy - statistics & numerical data Colorectal cancer Colorectal carcinoma Confidence intervals Demographics Disease control Endoscopy Female Gastroenterology General Surgery Health care Health care access Health Care Surveys Humans Large intestine Male Medicaid Medical personnel Medical screening Medicare Medicine Middle Aged NAMCS Patients Physicians Polls & surveys Procedures and Techniques Utilization - statistics & numerical data Rural Rural areas Rural Health Services - statistics & numerical data Surgeons Surgical education Urban areas Young Adult |
| title | Colonoscopy utilization in rural areas by general surgeons: An analysis of the National Ambulatory Medical Care Survey |
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