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Canadian Journal of Gastroenterology
Volume 21, Issue 7, Pages 431-434
Original Article

Colonoscopy and Flexible Sigmoidoscopy Practice Patterns in Ontario: A Population-Based Study

Susan E Schultz,1 Chris Vinden,1,2 and Linda Rabeneck1,3,4,5

1Institute for Clinical Evaluative Sciences, Toronto, Canada
2Department of Surgery, University of Western Ontario, London, Canada
3Toronto Sunnybrook Regional Cancer Centre, Canada
4Department of Medicine, University of Toronto, Toronto, Ontario, Canada
5Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada

Received 26 April 2006; Accepted 11 September 2006

Copyright © 2007 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


OBJECTIVE: To conduct a population-based study on the provision of large bowel endoscopic services in Ontario.

METHODS: Data from the following databases were analyzed: the Ontario Health Insurance Plan, the Institute for Clinical Evaluative Sciences Physicians Database and Statistics Canada. The flexible sigmoidoscopy and colonoscopy rates per 10,000 persons (50 to 74 years of age) by region between April 1, 2001, and March 31, 2002, were calculated, as well as the numbers and types of physicians who performed each procedure.

RESULTS: In 2001/2002, a total of 172,108 colonoscopies and 43,400 flexible sigmoidoscopies were performed in Ontario for all age groups. The colonoscopy rate was approximately five times that of flexible sigmoidoscopy; rates varied from 463.1 colonoscopies per 10,000 people in the north to 286.8 colonoscopies per 10,000 people in the east. Gastroenterologists in all regions tended to perform more procedures per physician, but because of the large number of general surgeons, the total number of procedures performed by each group was almost the same.

CONCLUSION: Population-based rates of colonoscopies and flexible sigmoidoscopies are low in Ontario, as are the procedure volumes of approximately one-quarter of physicians.