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 3 1, 2002 was determined. Individuals were followed over I 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 I 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.