We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Medical News & Perspectives |

Colonoscopy: Prime Time for Primary Care?

Rebecca Voelker
JAMA. 2009;301(9):921-922. doi:10.1001/jama.2009.238.
Text Size: A A A
Published online


A recent study suggests a way to derail the possibilityof too few specialists to meet future demand for colonoscopy: bridge the gap with properly trained primary care physicians. But this scenario raises timely questions, about what constitutes proper training in colonoscopy for primary care physicians and whether capacity for colorectal cancer screening really will fall short of demand.

Authors of a meta-analysis published in January say that adequately trained primary care physicians can perform colonoscopy as safely and effectively as endoscopists and gastroenterologists. The analysis included 12 studies reporting outcomes from 18 292 colonoscopies performed by 73 primary care physicians. Their adenoma and adenocarcinoma detection rates were 28.9% and 1.7%, respectively. They were able to reach the cecum—the anatomical landmark of a complete examination—in 89.2% of procedures. Major complications occurred in 0.04% of the procedures, including 3 perforations. No deaths were reported (Wilkins T el al. Ann Fam Med. 2009;7[1]:56-62).

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption

Graphic Jump LocationImage not available.

Improved training rather than improved technology may help colonoscopists detect polyps and perform complete examinations.



Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 1

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Clinical Scenario

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Clinical Scenario