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  1. Trends in use of barium enema examination, colonoscopy, and sigmoidoscopy : is use commensurate with risk of disease ?

    Article - En anglais


    To assess replacement of barium enema examination with colonoscopy in relation to age-and sex-related risk factors, place of service, physician specialty, and cost.


    Between 1985 and 1992,894,777 insurance claims for barium enema examination and lower gastrointestinal endoscopy were retrospectively examined.

    Changes in use were investigated.

    Use of proctosigmoidoscopy and flexible sigmoidoscopy, two office-based endoscopic procedures, was also examined.


    Use of diagnostic colonoscopy increased from 191 to 406 services per 100,000 persons ; colonoscopy with biopsy, from 77 to 183 services ; and colonoscopy with lesion removal, from 77 to 202 services.

    Barium enema examination use declined from 929 to 511 services per 100,000 persons ; diagnostic proctosigmoidoscopy, from 854 to 193 services ; and diagnostic flexible sigmoidoscopy, from 656 to 620 services.

    Increases in use of colonoscopy in patients aged younger than 40 years were greater than overall increases.


    Colonoscopy has been replacing barium enema examination as the initial colorectal examination since 1985.

    Increased use of colonoscopy in patients with lower risk of neoplasia suggests that indications have become overly broad.

    Mots-clés Pascal : Exploration radiologique, Lavement baryté, Endoscopie, Colonoscopie, Sigmoïdoscopie, Evolution, Prescription, Analyse avantage coût, Homme, Appareil digestif pathologie

    Mots-clés Pascal anglais : Radiologic investigation, Barium enema, Endoscopy, Colonoscopy, Sigmoidoscopy, Evolution, Prescription, Cost benefit analysis, Human, Digestive diseases

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0362952

    Code Inist : 002B24E06. Création : 01/03/1996.