期刊
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
卷 11, 期 1, 页码 65-U197出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.cgh.2012.08.009
关键词
Prevention; Early Detection; Colon Cancer Screening; Cost Efficacy
资金
- Comparative Effectiveness Research on Cancer in Texas grant [RP101207]
- Cancer Prevention Research Institute of Texas
- National Institutes of Health [1R01 CA134275, 1K05 CA134923]
BACKGROUND & AIMS: Patients treated with surgery for colorectal cancer (CRC) should undergo colonoscopy examinations 1, 4, and 9 years later, to check for cancer recurrence. We investigated the use patterns of surveillance colonoscopies among Medicare patients. METHODS: We used the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database to identify patients who underwent curative surgery for colorectal cancer from 1992 to 2005 and analyzed the timing of the first 3 colonoscopies after surgery. Early surveillance colonoscopy was defined as a colonoscopy, for no reason other than surveillance, within 3 months to 2 years after a colonoscopy examination with normal results. RESULTS: Approximately 32.1% and 27.3% of patients with normal results from their first and second colonoscopies, respectively, underwent subsequent surveillance colonoscopies within 2 years (earlier than recommended). Of patients who were older than 80 years at their first colonoscopy, 23.6% underwent a repeat procedure within 2 years for no clear indication. In multivariable analysis, early surveillance colonoscopy was not associated with sex, race, or patients' level of education. There was significant regional variation in early surveillance colonoscopies among the Surveillance, Epidemiology, and End Results regions. There was a significant trend toward reduced occurrence of second early surveillance colonoscopies. CONCLUSIONS: Many Medicare enrollees who have undergone curative resection for colorectal cancer undergo surveillance colonoscopy more frequently than recommended by the guidelines. Reducing overuse could free limited resources for appropriate colonoscopy examinations of inadequately screened populations.
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