Colonoscopy Demand and Practice in a Regional Hospital over 9 Years in Hong Kong: Resource Implication for Cancer Screening

• Published in: Digestion Vol. 73; no. 2-3; pp. 84 - 88
• Main Authors: Chan, Annie O.O., Hui, Wai Mo, Chan, Chi Kuen, Lai, Kam Chuen, Hu, Wayne H.C., Yuen, Man Fung, Wong, Wai Man, Lau, George K.K., Hui, Chi Kin, Lam, Shiu Kum, Wong, Benjamin C.Y.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2006
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Chi-Square Distribution; Colonoscopy - utilization; Colorectal Neoplasms - epidemiology; Female; Health Services Needs and Demand; Hong Kong - epidemiology; Humans; Incidence; Male; Mass Screening; Middle Aged; Original Paper; Waiting Lists; Hong Kong; Colonoscopy screening; Resource implication; Colorectal cancer
• ISSN: 0012-2823; 1421-9867
• DOI: 10.1159/000094038

Background: The incidence of colorectal cancer (CRC) in Hong Kong is rising. The trend of colonoscopy demand is uncertain. Aim: To investigate colonoscopy demand and practice in a Hong Kong regional hospital over the past nine years. Methods: Colonoscopy data from 1st January 1997 to 31st August 2005 were retrieved and divided into two equal periods for comparison. Colonoscopy practice and findings between the two periods were compared. Results: There was no change in the number of endoscopists and colonoscopy sessions in the two periods. The number of colonoscopy done in the two periods was 2,681 and 2,871, respectively. The indications for screening of CRC/polyp (9.3 vs. 24.7%, p < 0.0001) and surveillance of CRC/polyp (4.7 vs. 10.9%, p < 0.0001) were increased, but decreased for diarrhea (18 vs. 10.2%, p < 0.0001) and per rectal bleeding (19 vs. 8.1%, p < 0.0001). The waiting time was lengthened from 2 to 4 weeks (p < 0.0001). The percentage of colonic adenomas (19.9 vs. 27.2%, p < 0.0001) was increased. A right-shift was observed in both CRC (37 vs. 50%, p = 0.018) and adenoma (21.6 vs. 38.1%, p < 0.0001). Conclusion: The number of colonoscopies performed was governed by capacity partly through lengthening of waiting time to cope with demand. Ways to improve capacity for colonoscopies is needed.