The rate of colonoscopies performed by family physicians decreased between 2016 and 2021, according to a 2024 study published in the Journal of Rural Health.
The decrease was even more dramatic in rural parts of the U.S., according to a July 4 report from the American Journal of Managed Care.
Historically, family physicians have performed colonoscopies in the U.S. to increase patient access, as an average 30% of adults ages 50 to 75 in the U.S. are not up to date with their screening. The majority of unscreened patients come from rural areas and identify as Black, Hispanic or American Indian, the report said.
The study used the Merative's Marketscan database to review colonoscopies performed between January 2016 and December 2021. The data from inpatient, outpatient and drug claims is drawn from 300 employers and health plans across the country.
U.S. Census data and National Center for Health Statistics' Urban-Rural classification scheme were used to determine the metropolitan statistical area of each beneficiary. The study looked at 2,943,900 colonoscopies in the database, with 2016 having the highest number at 564,255 colonoscopies and 2020 having the lowest number at 365,172.
The percentage of colonoscopies performed by family practitioners fell from 11.32% in 2016 to just 6.73% in 2021.
The decrease mainly came from patients in rural areas, with men and slightly older patients more likely to get a colonoscopy from family practitioners.
Family practitioners were more likely to perform colonoscopies on patients living in rural areas, and patients in the Midwest also had their colonoscopies performed by family practitioners more often than other medical specialties.
Though the percentage of family practitioners performing colonoscopies declined over the five-year period, the researchers said family practitioners still perform a significant amount of procedures.