Immediate Perforation Risk Is Higher with Non-Gastroenterologist Endoscopist

Performance of colonoscopy by non-gastroenterologists in the U.S. has been associated with an increased risk for colorectal cancer after colonoscopy, lower adenoma detection rates, and overuse of colonoscopy for screening and surveillance. Is it also associated with immediate perforation during colonoscopy?

To answer this question, researchers evaluated risk factors for immediate perforation (perforation occurring during the procedure) using the Clinical Outcomes Research Initiative database. Of 1,144,900 colonoscopies performed in 85 centers, they identified 192 perforations.

Risk factors for perforation included any therapy (odds ratio, 3.93), large polyp size (OR, 4.14), performance in university hospitals (OR, 2.83), performance at VA hos…