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Date of Graduation

8-2005

Degree Type

Capstone Project (On-Campus Access Only)

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Jonathan W. Gietzen, MS, PA-C

Abstract

Background: It is estimated that there will be 145,290 new cases of colon cancer diagnosed in 2005 in the United States. When detected early, there is a five-year survival rate of ninety percent. Despite these numbers, less than fifty percent of the population over age fifty has undergone sigmoidoscopy or colonoscopy. The American Society of Colon and Rectal Surgeons, the US Preventative Task Force, and the, American Cancer Society all agree on the screening recommendations. Colonoscopies are held as the gold standard for screening, yet due to cost-effectiveness models there is not a clear recommendation of colonoscopy above other screening options. Colonoscopies are the only screening test that is diagnostic and therapeutic. All other positive screenings will be referred to colonoscopy and patents with polyps will undergo increased screening by colonoscopy in following years. With a lifetime risk of developing colorectal cancer of 2.5 to 5 percent, it is one of the most pervasive cancers. It has also been shown to be one of the most preventable cancers with adequate screening of polyps. Due to barriers such as cost, lack of patient education, and patient compliance, national screening rates rem ain low. Colonoscopies present many of the greatest of these barriers, and yet offer the most comprehensive exam.

Objective: To analyze demographic data from the calendar year 2004 on all colonoscopies performed at the Providence Hood River Memorial Hospital to compare actual colonoscopy results for this locale to published studies and provide a benchmark for future studies.

Design: Retrospective electronic chart review of all colonoscopy patients at Providence Hood River Memorial Hospital.

Setting: Hood River, OR. A federally designated rural health area.

Participants: All comers for colonoscopies during the calendar year 2004.

Measurements: All demographic data obtainable through electronic medical records including, but not limited to, age, gender, race, diagnosis, procedure, insurance, clinician, and location.

Results: A total of 500 colonoscopies were performed at PHRMH during the calendar year 2004. Ages ranged from 25 t6 94, with a mean age of 61.9. Gender was split almost equally, with 51.8 percent males and 48.2 percent females. 98.4 percent had insurance of some sort, leaving only 1.6 percent as self pay. There were an overall of 53 physicians . referring for colonoscopy services. 80 percent of patients were from Oregon.

Conclusions: While this study had significant limitations as to the predictive rates of overall CRC screening adherence, it did give valuable information as to the use of colonoscopy usage in the Hood River area. It demonstrates that services are being well utilized, but are likely under possible full capacity. There would likely be room for further growth in colonoscopy services with promotion of available services.

Comments

The digital version of this project is currently unavailable to off-campus users; however, it may be requested via interlibrary loan by eligible borrowers from Pacific University Library. Pacific University Library is a free lender. (Library Use: NL)

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