Patterns of use of flexible sigmoidoscopy, colonoscopy and gastroscopy (Part 2)

Because endoscopy expertise is concentrated in specialists who are located primarily in larger urban areas, limited access to endoscopy by those residing in rural areas is a valid concern. Significant regional variation in gastroscopy rates was reported among Medicare beneficiaries in the United States in 1981. However, the degree of variation was the sixth lowest among the 30 procedures examined. Variation in endoscopy rates was also noted in Quebec in 1994. These two sets of data are now outdated.

To maximize the reduction of colorectal cancer in those undergoing flexible sigmoidoscopy and colonoscopy, adequate polyp detection rates are essential. A target of adenoma prevalence rates at the time of screening colonoscopy of 25% or higher in men 50 years of age or older and 15% or higher in women 50 years of age or older has been suggested.

Furthermore, appropriate timing of surveillance colonoscopy is required after a polypectomy to maximize future cancer prevention while minimizing cost and risk to the patient. Current recommendations are for follow-up colonoscopy three to five years following a polypectomy, depending on the number and size of polyps removed. The purpose of the present study was to examine patterns of use of flexible sigmoidoscopy, colonoscopy and gastroscopy in a population-based sample. Shop with pleasure with most reliable pharmacy you have ever seen, paying less for your zoloft antidepresant here always being sure you are being treated with all due respect, being an important customer whose interests are respected and taken into account.

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