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. 2020 Jan;11(1):e00113.
doi: 10.14309/ctg.0000000000000113.

Trends in Wait Time for Colorectal Cancer Screening and Diagnosis 2013-2016

Jeffrey Hubers  1 , Amnon Sonnenberg  2 , Deepak Gopal  1 , Jennifer Weiss  1 , Thomas Holobyn  1 , Anurag Soni  1
Affiliations

Trends in Wait Time for Colorectal Cancer Screening and Diagnosis 2013-2016

Jeffrey Hubers et al. Clin Transl Gastroenterol. 2020 Jan.

Abstract

Objectives: Colorectal cancer (CRC) screening has increased in the United States during the past 20 years, resulting in an increased demand for colonoscopy. We tested the hypothesis that such increase resulted in longer wait times for colonoscopy and influenced CRC diagnosis.

Methods: A total of 36,623 consecutive colonoscopies performed at the University of Wisconsin from April 8, 2013, until December 31, 2016, were included in the analysis. Wait times for colonoscopy were stratified by consecutive 6-month periods and indications of screening/surveillance vs diagnostic colonoscopy.

Results: Despite unchanged number of endoscopists, more colonoscopies were performed in 2015-2016 than in 2013-2014 (20,897 vs 15,726, respectively, P = 0.004). The mean wait time for colonoscopy increased from 68 days in 2013-2014 to 111 days in 2015-2016 (P < 0.0001), with most change affecting screening/surveillance colonoscopy. In 170 patients with a newly diagnosed CRC, the wait time did not significantly change between 2013-2014 and 2015-2016 (21 vs 27 days, respectively, P = 0.2206).

Discussion: An increase in screening/surveillance colonoscopies resulted in a substantial rise in the number of procedures between 2013 and 2016. This increase was associated with longer wait times for screening/surveillance but not diagnostic colonoscopy. Longer wait times did not result in later CRC stage at diagnosis.

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Figures

Figure 1.
Figure 1.
Time trends of the number of referrals for colonoscopy over the study period, stratified by indication for the examination. There was a significant increase in the number of screening/surveillance colonoscopies performed, whereas the number of diagnostic examinations stayed constant.
Figure 2.
Figure 2.
Time trends of wait times stratified by indication for all colonoscopies (top) and for colonoscopies leading to cancer diagnosis (bottom). ALLCRC, all colorectal cancer patients; dx, diagnostic colonoscopy; DxCRC, patients with CRC diagnosed on diagnostic colonoscopy; ScSv, screening/surveillance colonoscopy; ScSvCRC, patients with CRC diagnosed on screening/surveillance colonoscopy.
See this image and copyright information in PMC

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