Colonoscopy by a family physician: a 9-year experience of 1048 procedures

J Fam Pract. 1996 Dec;43(6):561-6.


Background: In the last 15 years, family physicians and general internists have adopted flexible fiberoptic endoscopy as a procedure to screen patients at risk of premature death from colorectal cancer. There has been controversy regarding the ability of non-fellowship-trained primary care physicians to extend this experience to full colonoscopy.

Methods: The results of 1048 consecutive colonoscopy examinations performed by a family physician over a 9-year period were tabulated. Outcomes measured included the reach-the-cecum rate (RCR), use of medication, complication rate, and diagnostic yield. In a convenience sample of 110 cases, the effectiveness of the non-narcotic analgesic ketorolac was assessed by the RCR. Outcomes of cases in which ketorolac was used were compared with cases in which traditional sedation and analgesia were used.

Result: A high diagnostic yield without significant complications was noted. The RCR for nonmedicated patients was 36%. Among all medicated cases, the RCR was 93%. In patients who were given the non-narcotic analgesic ketorolac, the RCR was 96%, compared with 95% in patients not given ketorolac.

Conclusions: A family physician in rural practice was able to attain and sustain a state-of-the-art, reach-the-cecum rate over a 9-year period. This service resulted in a high diagnostic yield, high degree of safety, and satisfactory results for the community. Ketorolac is an effective alternative for patients who may be hypersensitive to narcotic analgesia/sedation.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics, Non-Narcotic / administration & dosage
  • Analgesics, Opioid / administration & dosage
  • Cecum
  • Colonic Neoplasms / diagnosis*
  • Colonoscopy / adverse effects
  • Colonoscopy / methods
  • Colonoscopy / standards*
  • Drug Combinations
  • Evaluation Studies as Topic
  • Family Practice / standards*
  • Female
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Ketorolac
  • Male
  • Meperidine / administration & dosage
  • Midazolam / administration & dosage
  • Middle Aged
  • Tolmetin / administration & dosage
  • Tolmetin / analogs & derivatives


  • Analgesics, Non-Narcotic
  • Analgesics, Opioid
  • Drug Combinations
  • Hypnotics and Sedatives
  • Meperidine
  • Tolmetin
  • Midazolam
  • Ketorolac