title: Colonoscopy demand and practice in a regional hospital over 9 years in Hong Kong: resource implication for cancer screening.
abstract: BACKGROUND
  The incidence of colorectal cancer (CRC) in Hong Kong is rising. The trend of colonoscopy demand is uncertain.
  
  
  OBJECTIVE
  To investigate colonoscopy demand and practice in a Hong Kong regional hospital over the past nine years.
  
  
  METHODS
  Colonoscopy data from 1st January 1997 to 31st August 2005 were retrieved and divided into two equal periods for comparison. Colonoscopy practice and findings between the two periods were compared.
  
  
  RESULTS
  There was no change in the number of endoscopists and colonoscopy sessions in the two periods. The number of colonoscopy done in the two periods was 2,681 and 2,871, respectively. The indications for screening of CRC/polyp (9.3 vs. 24.7%, p < 0.0001) and surveillance of CRC/polyp (4.7 vs. 10.9%, p < 0.0001) were increased, but decreased for diarrhea (18 vs. 10.2%, p < 0.0001) and per rectal bleeding (19 vs. 8.1%, p < 0.0001). The waiting time was lengthened from 2 to 4 weeks (p < 0.0001). The percentage of colonic adenomas (19.9 vs. 27.2%, p < 0.0001) was increased. A right-shift was observed in both CRC (37 vs. 50%, p = 0.018) and adenoma (21.6 vs. 38.1%, p < 0.0001).
  
  
  CONCLUSIONS
  The number of colonoscopies performed was governed by capacity partly through lengthening of waiting time to cope with demand. Ways to improve capacity for colonoscopies is needed.
authors.affiliation: Department of Medicine, University of Hong Kong, SAR, China.
authors.forename: Annie O O
authors.initials: AO
authors.lastname: Chan
authors.forename: Wai Mo
authors.initials: WM
authors.lastname: Hui
authors.forename: Chi Kuen
authors.initials: CK
authors.lastname: Chan
authors.forename: Kam Chuen
authors.initials: KC
authors.lastname: Lai
authors.forename: Wayne H C
authors.initials: WH
authors.lastname: Hu
authors.forename: Man Fung
authors.initials: MF
authors.lastname: Yuen
authors.forename: Wai Man
authors.initials: WM
authors.lastname: Wong
authors.forename: George K K
authors.initials: GK
authors.lastname: Lau
authors.forename: Chi Kin
authors.initials: CK
authors.lastname: Hui
authors.forename: Shiu Kum
authors.initials: SK
authors.lastname: Lam
authors.forename: Benjamin C Y
authors.initials: BC
authors.lastname: Wong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D005260:Female; D006301:Health Services Needs and Demand; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D014850:Waiting Lists