Why Has the Number of Colonoscopies Tripled in the Last Decade?

By: Dr. Kim Riviello DNP, MBA, CRNA   |  President   |  Anesthesia Services Group 

On March 17, 2014, headlines released by USA TODAY and the WALL STREET JOURNAL praised the fact that the screening rate for colon cancer has nearly tripled in the last decade. It has gone from 19% in 2000 to 55% in 2010 according to a recent study by the American Cancer Society.

As a healthcare provider, this is great news (for once) about something positive occurring in the healthcare industry. However, as an anesthetist who provides anesthesia services to GI facilities, I ask, “Why?” “Why has the screening rate tripled in the last decade?” There was no mention in either article explaining why this trend has occurred. Both articles addressed the positive effect of the increased screening related to a decrease in colon cancer. But what has driven more people to get colonoscopies? Is it because patients know they can get an anesthetic with their colonoscopy that is administered by an anesthesia clinician who will provide Propofol; the drug that causes you to sleep through this gut wrenching procedure and then allows you to awake quickly with no side effects or hangover? Propofol was introduced into the endoscopy suites in the late 1990s and early 2000s. Its use has progressively increased in the last 15 years to the point it is becoming the standard of care. A recent study looking at over 3000 patients presenting for EGDs and Colonoscopies, showed that patients presenting to the endoscopy suites have more high risk co-morbidities of diabetes, obesity, coronary artery disease, COPD than ever before, increasing the risk of colonoscopies. 

Anesthesia clinicians (CRNA and/or MD) within the endoscopy suite increase the safety and quality of the procedure by providing proper pre-op screening of these high risk patients and ensuring a safe and quality anesthetic during the colonoscopy. Now that patients are aware of the benefits of having anesthesia at their side for their colonoscopy they are more willing to have their screening performed. Anesthesia cannot be denied some credit for why colon screenings have tripled over the last decade. So let anesthesia continue to do what they do best and we will see an even further increase in colon screening. 

Sources: A Study of the co-morbidity risk of patients in freestanding surgery facilities; a retrospective study of a gastroenterology facility: Are the patients sicker?