Patients are significantly less likely to develop colorectal cancer after a negative colonoscopy if the screening is performed by a gastroenterologist rather than a non-specialist, according to a study that sheds light on the impact a physician's training can have on CRC screening outcomes.
"Colorectal cancers do occur in individuals following a negative colonoscopy," says lead author Linda Rabeneck, MD, MPH, of the University of Toronto. "For this reason, having extensive formal training matters, especially when procedures are more challenging to perform."
Dr. Rabeneck and colleagues studied 110,402 Ontario residents aged 50 to 80 who underwent a negative complete colonoscopy from 1992 through 1997. None of the patients had a history of CRC, inflammatory bowel disease or a recent colonic resection, and the majority of patients (86%) had their procedure done in a hospital.
Over a 15-year follow-up period, 14.5% of the patients developed colorectal cancer, according to results published in Clinical Gastroenterology and Hepatology. Among those who were screened in the hospital, the risk of subsequently developing CRC was almost 40% greater when a general surgeon performed the procedure than it was when a gastroenterologist did the screening. "This may reflect the considerable formal training in endoscopy that forms part of gastroenterology core training requirements in the U.S. and Canada," says Dr. Rabeneck.
The researchers found no significant correlation between endoscopist specialty and incident CRC in patients who underwent screening colonoscopies in private offices or clinics.
Irene Tsikitas
