title: Expanding Access to Colorectal Cancer Screening: Benchmarking Quality Indicators in a Primary Care Colonoscopy Program.
abstract: BACKGROUND
  An inadequate supply of physicians who perform colonoscopies contributes to suboptimal screening rates, especially among the underserved. This shortage could be reduced if primary care physicians perform colonoscopies. This purpose of this article is to report quality indicators from colonoscopy procedures performed by family medicine physicians as part of a colorectal cancer prevention program targeting uninsured, low-income individuals.
  
  
  METHODS
  A grant-funded colorectal cancer screening program was implemented to increase access to affordable colonoscopies for underinsured or uninsured residents of target counties while providing colonoscopy training to family medicine resident physicians. Colonoscopies were performed or supervised by 4 board-certified family physicians. Data were collected between 2011 and 2014.
  
  
  RESULTS
  A total of 1155 colonoscopies were performed on 1101 individuals over a 3-year period. Cecal intubation rate was 96.25%. Adenoma detection rates among men and women >50 years old were 38.15% and 25.96%, respectively. There was 1 perforation, which was referred to a hospital, and 1 instance of postprocedural bleeding, which spontaneously resolved.
  
  
  CONCLUSIONS
  Primary care physicians performing colonoscopies met the recommended quality indicators set forth by the American Society for Gastrointestinal Endoscopy.
authors.affiliation: From the Department of Clinical & Translational Medicine, College of Medicine, Texas A&M University, Bryan (DAM, RP, JS, KF, AR); Texas A&M Physicians Family Medicine Residency, Texas A&M University, Bryan (DAM, RP, JS, KF, AR, PN); the Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station (COO, JWH, JNB); and the Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station (MGO).
authors.forename: David A
authors.initials: DA
authors.lastname: McClellan
authors.affiliation: From the Department of Clinical & Translational Medicine, College of Medicine, Texas A&M University, Bryan (DAM, RP, JS, KF, AR); Texas A&M Physicians Family Medicine Residency, Texas A&M University, Bryan (DAM, RP, JS, KF, AR, PN); the Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station (COO, JWH, JNB); and the Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station (MGO). ojinnaka@sph.tamhsc.edu.
authors.forename: Chinedum O
authors.initials: CO
authors.lastname: Ojinnaka
authors.affiliation: From the Department of Clinical & Translational Medicine, College of Medicine, Texas A&M University, Bryan (DAM, RP, JS, KF, AR); Texas A&M Physicians Family Medicine Residency, Texas A&M University, Bryan (DAM, RP, JS, KF, AR, PN); the Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station (COO, JWH, JNB); and the Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station (MGO).
authors.forename: Robert
authors.initials: R
authors.lastname: Pope
authors.affiliation: From the Department of Clinical & Translational Medicine, College of Medicine, Texas A&M University, Bryan (DAM, RP, JS, KF, AR); Texas A&M Physicians Family Medicine Residency, Texas A&M University, Bryan (DAM, RP, JS, KF, AR, PN); the Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station (COO, JWH, JNB); and the Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station (MGO).
authors.forename: John
authors.initials: J
authors.lastname: Simmons
authors.affiliation: From the Department of Clinical & Translational Medicine, College of Medicine, Texas A&M University, Bryan (DAM, RP, JS, KF, AR); Texas A&M Physicians Family Medicine Residency, Texas A&M University, Bryan (DAM, RP, JS, KF, AR, PN); the Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station (COO, JWH, JNB); and the Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station (MGO).
authors.forename: Katie
authors.initials: K
authors.lastname: Fuller
authors.affiliation: From the Department of Clinical & Translational Medicine, College of Medicine, Texas A&M University, Bryan (DAM, RP, JS, KF, AR); Texas A&M Physicians Family Medicine Residency, Texas A&M University, Bryan (DAM, RP, JS, KF, AR, PN); the Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station (COO, JWH, JNB); and the Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station (MGO).
authors.forename: Andrew
authors.initials: A
authors.lastname: Richardson
authors.affiliation: From the Department of Clinical & Translational Medicine, College of Medicine, Texas A&M University, Bryan (DAM, RP, JS, KF, AR); Texas A&M Physicians Family Medicine Residency, Texas A&M University, Bryan (DAM, RP, JS, KF, AR, PN); the Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station (COO, JWH, JNB); and the Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station (MGO).
authors.forename: Janet W
authors.initials: JW
authors.lastname: Helduser
authors.affiliation: From the Department of Clinical & Translational Medicine, College of Medicine, Texas A&M University, Bryan (DAM, RP, JS, KF, AR); Texas A&M Physicians Family Medicine Residency, Texas A&M University, Bryan (DAM, RP, JS, KF, AR, PN); the Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station (COO, JWH, JNB); and the Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station (MGO).
authors.forename: Phillip
authors.initials: P
authors.lastname: Nash
authors.affiliation: From the Department of Clinical & Translational Medicine, College of Medicine, Texas A&M University, Bryan (DAM, RP, JS, KF, AR); Texas A&M Physicians Family Medicine Residency, Texas A&M University, Bryan (DAM, RP, JS, KF, AR, PN); the Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station (COO, JWH, JNB); and the Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station (MGO).
authors.forename: Marcia G
authors.initials: MG
authors.lastname: Ory
authors.affiliation: From the Department of Clinical & Translational Medicine, College of Medicine, Texas A&M University, Bryan (DAM, RP, JS, KF, AR); Texas A&M Physicians Family Medicine Residency, Texas A&M University, Bryan (DAM, RP, JS, KF, AR, PN); the Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station (COO, JWH, JNB); and the Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station (MGO).
authors.forename: Jane N
authors.initials: JN
authors.lastname: Bolin
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019985:Benchmarking; D003110:Colonic Neoplasms / Q000175:diagnosis; D003113:Colonoscopy / Q000592:standards*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards* / Q000706:statistics & numerical data; D017057:Medically Uninsured; D008875:Middle Aged; D011320:Primary Health Care; D019984:Quality Indicators, Health Care; D055815:Young Adult
keywords: Access to Health Care; Cancer; Colonoscopy; Prevention & Control; Primary Health Care