New Mexico's capacity for increasing the prevalence of colorectal cancer screening with screening colonoscopies.
BACKGROUND
Colorectal cancer screening rates are low throughout the United States. Colonoscopy has been recommended as a cost-effective strategy for colorectal cancer screening and prevention. We evaluated New Mexico's capacity to increase the prevalence of colorectal cancer screening using colonoscopy.


METHODS
We identified New Mexican gastroenterologists from state licensing data and from endoscopic manufacturers. We surveyed gastroenterologists on their weekly number of colonoscopies, capacity for additional screening colonoscopies, and barriers to increasing capacity. We used census data, published data on the yield of screening colonoscopy, and professional society guidelines for cancer/polyp surveillance to estimate the additional colonoscopies required to increase the state's prevalence of endoscopic screening.


RESULTS
Forty gastroenterologists, representing all 11 group practices in the state, and nine of 12 solo practitioners responded. They estimated that their weekly procedure capacity could be increased by 41%, from 832 to 1174 colonoscopies. We estimated an annual capacity increase of 14,880 procedures, which could increase the prevalence of endoscopic colorectal cancer screening from the current 35% to about 50% over five years. Lack of support staff, space, and physicians were barriers to increasing screening.


CONCLUSIONS
Implementing a screening colonoscopy strategy could achieve the goal of a higher level of colorectal screening. However, achieving more universal screening would require additional testing modalities.
Hoffman
Richard M
RM
New Mexico VA Health Care System 111GIM, 1501 San Pedro SE, Albuquerque, NM 87108, USA. rhoffman@unm.edu
Stone
S Noell
SN
Herman
Carla
C
Jung
Ann Moore
AM
Cotner
Jane
J
Espey
David
D
Kozoll
Richard
R
Gavin
Michael W
MW
D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005240:Feasibility Studies; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D009516:New Mexico