Uptake and Short-term Outcomes of High-risk Screening Colonoscopy Billing Codes: A Population-based Study Among Young Adults. Issue 2 (10th June 2021)

• Record Type: Journal Article
• Authors: Paszat, Lawrence; Sutradhar, Rinku; Luo, Jin; Tinmouth, Jill; Rabeneck, Linda; Baxter, Nancy N
• Is Part Of: Journal of the Canadian Association of Gastroenterology. Volume 5:Issue 2(2022)
• Page Start: 86
• Page End: 95
• Publication Date: 2021-06-10
• Subjects: Colorectal cancer family history -- Hereditary colorectal cancer syndromes -- Mean cumulative function -- Screening colonoscopy -- Surveillance colonoscopy; Gastroenterology -- Periodicals; 616.33005
• DOI: 10.1093/jcag/gwab014
• Languages: English
• ISSNs: 2515-2084

Abstract

Abstract: Background: Persons suspected or confirmed with familial colorectal cancer syndrome are recommended to have biennial colonoscopy from late adolescence or early adulthood. Persons without a syndrome but with one or more affected first-degree relatives are recommended to begin colonoscopy 10 years before the age at diagnosis of the youngest affected relative, and every 5 to 10 years. Ontario introduced colonoscopy billing codes for these two indications in 2011. Methods: We identified persons in Ontario under 50 years of age, without a prior history of colorectal cancer or inflammatory bowel disease, with one or more of these billing claims between 2013 and 2017. We described the index colonoscopy, and subsequent colonoscopy up-to-date status. We computed average annual rates of colorectal and other cancer diagnoses, and displayed mean cumulative function plots, stratified by billing code, age and sex. Results: Billing claims for 'familial syndrome' high-risk screening colonoscopy were identified among 14, 846 persons; the average annual rate of CRC diagnoses was 38.6 per 100, 000 among males and 22.2 among females. Colonoscopy up-to-date status fell to 50% within 7 years. Billing claims for 'first-degree relative' screening colonoscopy was identified among 49, 505 persons; average annual rates of CRC diagnoses were 16.3 among males and 13.5 per 100, 000 among females, respectively. Conclusion: Colorectal cancer was more frequent following billing claims for high-risk screening colonoscopy for familial syndromes, as were noncolorectal malignancies potentially associated with these syndromes. This billing claim for familial colorectal cancer syndrome colonoscopy appears to identify a group at elevated short-term risk for cancer.