Recommending Screening Colonoscopy in a Family Physician’s Practice
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Background: Since 2002, colonoscopy screenings for colon cancer have been designated for all German citizens aged 55 and older. Participation rates, however, are low. In his family practice, the first author tries to inform all patients about screening colonoscopy and to motivate them to participate. In a retrospective analysis of the routine practice documentation files, we investigated participation rates, reasons for non-participation and colonoscopy findings.Methods: All patients who received colonoscopy since 2002 having an age of at least 55 years, and all patients over 55 years who had never undergone colonoscopy until December 2017 were eligible for the analysis.Results: A total of 753 patients were included in the analysis. 546 patients (73 %) received at least one colonoscopy, 114 patients (14 %) either rejected the examination or showed contraindications, and 103 patient (13 %) were either overlooked or had not yet been contacted. In 262 of the patients receiving colonoscopy (48 %) an adenoma was found and 18 patients (3 %) had colon carcinoma (three of these patients had refused a screening colonoscopy). Complications were reported for two patients (0.4 %; one perforation and one relevant bleeding after removal of large adenomas). One patient died from colon carcinoma in the observational period.Conclusions: From routine files, it was not possible to ensure that all colonoscopies had been performed for screening purposes. The proportion of adenomas in our participants is higher than in other studies. Our findings suggest, that a systematic consultation strategy on the part of family physicians can enhance participation rates in colonoscopy screening.