Recommendations from medical specialists that healthy adults be screened for colon cancer has resulted in hundreds of thousands of people seeking colonoscopies, producing long waits for the test and straining hospital resources.
"The demand is endless and limitless and beyond anyone's expectations," Dr. William Brugge, director of endoscopy at Massachusetts General Hospital, told the Boston Sunday Globe. The hospital expects to conduct 25,000 colonoscopies and other gastrointestinal imaging procedures in 2004, a 20 percent jump in one year.
While statistics on colonoscopies are scarce, Medicare paid for 381,364 screening tests for healthy enrollees last year, more than double the number two years ago.
The demand has created waiting lists of up to six months at some hospitals. Others are able to meet the demand more quickly.
The Risk Management Foundation, which insures doctors affiliated with Harvard Medical School, said some patients who should have colonoscopies are not getting them.
Robert Hanscom, the foundation's director of loss prevention, said long waits may contribute to a new spate of lawsuits over colonoscopies, because patients have more time to back out of the test and doctors then lose track of them.
"It's evidence of a strained system," he said.
Cancer of the colon, or large intestine, and the rectum is the third most common cancer. It is also the second deadliest after lung cancer, killing more than 57,000 Americans annually. One in 17 men and one in 18 women develops colon cancer.
As medical specialists and celebrities have publicized the test, hospitals are expanding to meet the demand.
Lahey Clinic in Burlington, for example, is fielding 1,800 requests a month for colonoscopies, but can accommodate only 1,200 patients.
About two years ago, the hospital began scheduling patients on Saturdays. This year, Lahey hired schedulers to work at night, so that when a patient cancels, staff can scour the waiting list and call someone to fill the vacated slot.
Boston Medical Center, which began in January to schedule colonoscopies for Saturdays, projects that its doctors will perform 10,000 this year, more than double the number five years ago.
Still, medical specialists say, not enough people are getting screened for colon cancer.
According to the Centers for Disease Control and Prevention, 45 percent of men and 41 percent of women age 50 and over had undergone a colonoscopy or sigmoidoscopy, according to the most recent data in 2000. That means that millions more Americans should have screening tests, and agencies like the CDC are trying to reach them with information.
