Table 1.
Study population and characteristics of index colonoscopy.
| Clinical setting of index colonoscopy | Entire population | ||||
|---|---|---|---|---|---|
| Teaching hospital | Community hospital | Nonhospital facility | |||
| Number of patients | 35,988 (10.8%) | 181,039 (54.1%) | 117,636 (35.1%) | 334,663 | |
|
| |||||
| Patient factors | P value among strata | ||||
| Age | |||||
| 50–54 years | 8,722 (24.2%) | 45,437 (25.1%) | 39,953 (34.0%) | <0.0001 | 94,112 (28.1%) |
| 55–59 years | 7,423 (20.6%) | 37,220 (20.6%) | 26,255 (22.3%) | 70,898 (21.2%) | |
| 60–64 years | 7,039 (19.6%) | 33,708 (18.6%) | 21,102 (17.9%) | 61,849 (18.5%) | |
| 65–69 years | 6,003 (16.7%) | 30,313 (16.7%) | 16,406 (14.0%) | 52,722 (15.8%) | |
| 70–74 years | 4,212 (11.7%) | 21,050 (11.6%) | 9,520 (8.1%) | 34,782 (10.4%) | |
| 75–79 years | 2,589 (7.2%) | 13,311 (7.4%) | 4,400 (3.7%) | 20,300 (6.1%) | |
|
| |||||
| Female | 19,984 (55.5%) | 95,409 (52.7%) | 59,675 (50.7%) | <0.0001 | 175,068 (52.3%) |
| Male | 16,004 (44.5%) | 85,630 (47.3%) | 57,961 (49.3%) | 159,595 (47.7%) | |
|
| |||||
| Residence | |||||
| Income quintile 1 | 5,368 (14.9%) | 20,683 (11.42%) | 15,596 (13.3%) | <0.0001 | 41,647 (12.4%) |
| Income quintile 2 | 5,986 (16.6%) | 25,722 (14.2%) | 19,832 (16.9%) | 51,400 (15.4%) | |
| Income quintile 3 | 6,000 (16.7%) | 29,277 (16.2%) | 22,191 (18.9%) | 57,468 (17.2%) | |
| Income quintile 4 | 6,838 (19.0%) | 34,405 (19.0%) | 25,812 (21.9%) | 67,055 (20.0%) | |
| Income quintile 5 | 9,121 (25.3%) | 35,006 (19.3%) | 29,915 (25.4%) | 74,042 (22.1%) | |
| Rural | 2,675 (7.4%) | 35,946 (19.9%) | 4,290 (3.7%) | 42,911 (12.8%) | |
|
| |||||
| ADG score | |||||
| Mean (SD) | 4.91 (3.01) | 4.88 (2.82) | 4.24 (2.63) | <0.0001 | 4.72 (2.79) |
| Median (IQR) | 4 (3, 7) | 4 (3, 7) | 4 (2, 6) | 4 (3–6) | |
|
| |||||
| Colonoscopy factors | |||||
| Complete | 34,844 (96.8%) | 177,338 (98.0%) | 115,772 (98.4%) | <0.0001 | 327,954 (98.0%) |
| Incomplete | 1,144 (3.2%) | 3,701 (2.0%) | 1,864 (1.6%) | 6,709 (2.0%) | |
|
| |||||
| Open access | 21,584 (60.0%) | 58,834 (32.5%) | 85,148 (72.4%) | <0.0001 | 165,566 (49.5%) |
| Not open access | 14,404 (40.0%) | 122,205 (67.5%) | 32,488 (27.6%) | 169,097 (50.5%) | |
|
| |||||
| Most complex procedure at index colonoscopy | |||||
| “Removal of large polyp or obstructing lesion” | 228 (0.6%) | 1,284 (0.7%) | 609 (0.5%) | <0.0001 | 2,121 (0.6%) |
| Standard polypectomy | 6,060 (16.8%) | 32,412 (17.9%) | 18,875 (16.1%) | 57,347 (17.1%) | |
| Biopsy | 6,368 (17.7%) | 21,195 (11.7%) | 8,965 (7.6%) | 36,528 (10.9%) | |
| None of the above or none | 23,332 (64.8%) | 126,148 (69.7%) | 89,187 (75.8%) | 238,667 (71.3%) | |
|
| |||||
| Endoscopist factors ∗ | |||||
| Female | 68 (24.3%) | 145 (19.5%) | 123 (17.3%) | 0.05 | 215 (20.9%) |
| Male | 212 (75.7%) | 597 (80.5%) | 579 (81.8%) | 810 (78.6%) | |
|
| |||||
| Endoscopist specialty | |||||
| Gastroenterology | 110 (39.3%) | 159 (21.4%) | 196 (27.5%) | <0.0001 | 250 (24.4%) |
| General surgery | 117 (41.2%) | 420 (56.6%) | 351 (49.3%) | 512 (49.9%) | |
| Internal medicine | 43 (15.4%) | 76 (10.2%) | 108 (15.2%) | 130 (12.7%) | |
| Other | 10 (3.6%) | 87 (11.7%) | 57 (8.0%) | 133 (13.0%) | |
|
| |||||
| Endoscopist prior year practice factors | |||||
| Prior year colonoscopy volume | Mean: 406.6 | 533.6 | Mean: 554.9 | <0.0001 | Mean 468.8 |
| (SD: 439.0) | (SD 419.7) | (SD: 433.2) | (SD 407.2) | ||
| Median 305 | Median 455 | Median 492 | Median 384 | ||
| (IQR 94–559) | (IQR 214–755) | (IQR 224–755) | (IQR 150–661) | ||
|
| |||||
| Prior year volume “removal of large polyp or obstructing lesion” | Mean: 3.8 | Mean: 3.9 | Mean: 4.5 | <0.0001 | Mean 3.5 |
| (SD: 11.8) | (SD: 11.1) | (SD: 12.3) | (SD 10.7) | ||
| Median 0 | Median: 0 | Median: 1 | Median 0 | ||
| (IQR 0–3) | IQR (0–4) | (IQR 0–4) | (IQR 0–3) | ||
|
| |||||
| Prior year standard polypectomy volume | Mean: 132.5 | Mean: 188.8 | Mean: 195.5 | <0.0001 | Mean 163.4 |
| (SD: 179) | (SD: 185.6) | (SD: 199.9) | (SD 182.7) | ||
| Median 85 | Median: 136 | Median: 142 | Median 110 | ||
| (IQR 25–168) | (IQR 62–260) | (IQR 61–275) | (IQR 38–232) | ||
|
| |||||
| Prior year cecal intubation rate | Mean 0.92 | Mean 0.95 | Mean 0.95 | <0.0001 | Mean 0.94 |
| (SD 0.09) | (SD 0.07) | (SD 0.09) | (SD 0.09) | ||
| Median 0.94 | Median 0.96 | Median 0.96 | Median 0.96 | ||
| (IQR 0.91–0.97) | (IQR 0.94–0.98) | (IQR 0.93–0.98) | (IQR 0.93–0.98) | ||
∗(The majority of endoscopists performed colonoscopy at two or more settings.)