How Do I Choose the Best Doctor for My Colonoscopy?



Let’s say it’s time for your very first screening colonoscopy. How do you choose your gastroenterologist for your procedure? You may look online for gastroenterologists in your area. You may ask your friends for a recommendation. But which doctor is the right one for you? The short answer is: the doctor who finds the most polpys!

Study Links Polyp Detection Rate to Colon Cancer Rate

According to a study published by the New England Journal of Medicine, the likelihood of developing colon cancer is significantly reduced among individuals whose doctors removed a greater number of adenomas, or premalignant polyps. The study examined 300,000 screening colonoscopies performed by 136 physicians who had performed at least 300 colonoscopies. Among the physicians, the polyp detection rate ranged from 7.4 and 52.5 percent. They physicians were divided into five groups according to their polyp detection rate. The research team then assessed the number of colon cancers that resulted between six months and 10 years after screening.

For patients whose doctors had the highest percentage of polyp detection, their colon cancer rate was about 50 percent of the rate whose doctors fell into the lowest group for polyp detection. Patients with fatal colon tumors also had much higher rate of survival with physicians who had high detection rates. Researchers also documented that physician skill affects the stage at which colon and rectal cancers are discovered.

Therefore, it would seem that there is an inverse relationship between a gastroenterologist’s frequency in removing benign polyps and their patients developing colon cancer. In the New England Journal of Medicines’ blog, it reads, “each 1 percent increase in adenoma detection rate brought with it a 3 percent decrease in interval cancer risk and a 5 percent decrease in risk of fatal colon cancer.”

What Affects a GI’s Polyp Detection Rate?

This study actually prompts new questions such as, “Why is there such a wide range of polyp detection rates among physicians?” There are many factors that affect detection rates such as:

  • Demographics— physician who serve older populations may detect more polyps
  • Colon prep— how well the gut has been cleansed affects detection rates
  • Patient insurance and reimbursement— how much the doctor is being reimbursed for the procedure may affect the thoroughness of the procedure

Spending More Time “Down There” Matters

Probably the most significant factor in polyp detection rates is how long and hard the physician actively looks for polyps. Sometimes, it just comes down to how much time your doctor spends in your colon. If a doctor passes the colonoscope through the entire colon and diligently scopes for polyps until the scope nears the appendix at the end of the right colon, the chances of polyp detection are higher.

Take Time to Ask Questions

So if it’s time for your first colonoscopy, don’t be afraid to ask your doctor questions such as:

  1. What is your experience in performing colonoscopies?
  2. How long does the procedure normally take you to perform?
  3. What is your polyp detection rate for patients my age?

Never be hesitant to ask questions. Your colonoscopy can be a window into your health. Do your part by preparing for the procedure thoroughly and by asking good qualifying questions to your doctor. The proof is in numbers, so find a doctor with high detection rates (Source: Forbes).