Rates of complete colonic evaluation after incomplete colonoscopy and their associated factors: a population-based study

Background — With the increasing use of colonoscopy there is growing concern about the quality of these procedures.

Objective — To evaluate the rates of complete colonic evaluation after an incomplete colonoscopy and their associated factors.

Methods — Men and women ≥50 years old living in Ontario on January 1, 1997 who did not have a prior history of colorectal cancer, inflammatory bowel disease, or colonic resection comprised the inception cohort. Receipt of an incomplete colonoscopy between January 1, 1997 and December 31, 2002 was determined. Individuals were followed over 1 year and the time from incomplete colonoscopy to complete colonic evaluation was estimated using Kaplan-Meier analysis. A generalized estimating equations model was used to evaluate the association between patient, physician, and setting factors and complete colonic evaluation.

Results — Twenty thousand one hundred sixty-six individuals had an incomplete colonoscopy, of whom 29.4% underwent complete colonic evaluation within 1 year after the procedure. Women ≥80 years were less likely to undergo complete colonic evaluation (odds ratio: 0.89; 95% confidence interval: 0.79–0.99), as were those who had their colonoscopy in a private office or clinic (odds ratio: 0.77; 95% confidence interval: 0.67–0.89).

Conclusions — Only 29.4% of individuals with an incomplete colonoscopy underwent complete colonic evaluation within 1 year after the procedure. Women ≥80 years and those who had their colonoscopy in a private office or clinic were less likely to undergo complete colonic evaluation. The quality of care provided to older women and colonoscopy practice in office settings may be suboptimal.