Low-cost, office-based, screening colonoscopy

Am J Gastroenterol. 1994 Oct;89(10):1775-80.


Objectives: Performing full colonoscopy at regular intervals and removing lesions at an early stage might significantly lower the incidence and mortality of colorectal cancer. Such a program must be inexpensive, safe, and time-efficient.

Methods: Screening colonoscopy was performed on 639 patients. For a normal examination, the physician's time is limited to giving the medication for conscious sedation, performing the colonoscopy, and completing a written report form. The total charge for a normal screening colonoscopy is $150.

Results: Adenomatous and/or hyperplastic polyps were detected in 218 patients (34.1%). One hundred sixty adenomatous and 134 hyperplastic polyps were removed. Forty-eight percent (48.1%) of the adenomatous and 21.6% of the hyperplastic polyps were above the sigmoid colon. Six adenocarcinomas were detected in five patients. One patient had a delayed bleeding episode requiring no transfusion or therapeutic intervention, and one patient had a "post-polypectomy syndrome" requiring no therapeutic intervention. The average physician time in the endoscopy room for normal examinations was 18 min.

Conclusions: Screening colonoscopy can be safely performed in an office facility. Physician time with the patient should be limited to allow a low cost that compares favorably with screening costs for other malignancies. Long-term studies to assess the capability of screening colonoscopy to lower mortality from colorectal cancer should continue.

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenoma / diagnosis
  • Adenoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care
  • Colonic Polyps / diagnosis
  • Colonic Polyps / surgery
  • Colonoscopy* / economics
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / surgery
  • Costs and Cost Analysis
  • Female
  • Humans
  • Male
  • Middle Aged