scholarly journals Patterns of Use of Flexible Sigmidoscopy, Colonoscopy and Gastroscopy: A Population-Based Study in a Canadian Province

2004 ◽  
Vol 18 (4) ◽  
pp. 213-219 ◽  
Author(s):  
Robert J Hilsden

BACKGROUND & AIMS:Flexible sigmoidoscopy, colonoscopy and gastroscopy are important in the diagnosis and treatment of gastrointestinal (GI) diseases. Pressure on endoscopy resources is expected due to increased screening for GI cancers. The present study examined patterns of use of GI endoscopy in a Canadian province, Alberta, with universal health care insurance.METHODS:Data on physician payments from January 1, 1994 to March 31, 2002 were used to calculate age-sex adjusted rates and patterns of use.RESULTS:The gastroscopy rate increased by 17%, from 9.7 (95% CI 9.6 to 9.9) to 10.3 (95% CI 10.1 to 10.5). The colonoscopy rate increased by 105%, from 4.8 (95% CI 4.6 to 5.0) to 9.8 (95% CI 9.6 to 10.1). Flexible sigmoidoscopy rates declined by 10%, from 4.68 (95% CI 4.56 to 4.80) to 4.21 (95% CI 4.11 to 4.32). The increase in colonoscopy rates occurred in all age groups, whereas gastroscopy rates increased only in the older age groups. Regional variation in procedure rates was evident, but rural health regions did not have consistently lower rates than the large urban regions. A polypectomy was performed on 23.7% of male patients and 15.4% of female patients at time of colonoscopy. Rates of polypectomy for individual endoscopists ranged from 0% to 60%.CONCLUSIONS:There has been a marked increase in gastroscopy and colonoscopy rates, likely due to a broadening of indications rather than just increased use for cancer screening. Modest regional variation in rates exists, but there is no direct evidence of limited rural access to endoscopy. Reasonable polypectomy rates were seen but important variations between endoscopists exist.

2007 ◽  
Vol 21 (7) ◽  
pp. 431-434 ◽  
Author(s):  
Susan E Schultz ◽  
Chris Vinden ◽  
Linda Rabeneck

OBJECTIVE: To conduct a population-based study on the provision of large bowel endoscopic services in Ontario.METHODS: Data from the following databases were analyzed: the Ontario Health Insurance Plan, the Institute for Clinical Evaluative Sciences Physicians Database and Statistics Canada. The flexible sigmoidoscopy and colonoscopy rates per 10,000 persons (50 to 74 years of age) by region between April 1, 2001, and March 31, 2002, were calculated, as well as the numbers and types of physicians who performed each procedure.RESULTS: In 2001/2002, a total of 172,108 colonoscopies and 43,400 flexible sigmoidoscopies were performed in Ontario for all age groups. The colonoscopy rate was approximately five times that of flexible sigmoidoscopy; rates varied from 463.1 colonoscopies per 10,000 people in the north to 286.8 colonoscopies per 10,000 people in the east. Gastroenterologists in all regions tended to perform more procedures per physician, but because of the large number of general surgeons, the total number of procedures performed by each group was almost the same.CONCLUSION: Population-based rates of colonoscopies and flexible sigmoidoscopies are low in Ontario, as are the procedure volumes of approximately one-quarter of physicians.


2021 ◽  
Vol 24 (8) ◽  
pp. 629-635
Author(s):  
Adel Ebrahimpour ◽  
Mohammadreza Chehrassan ◽  
Mehrdad Sadighi ◽  
Mehdi Azizmohammad Looha ◽  
Amin Karimi ◽  
...  

Background: Primary osseous sarcomas of the mobile spine are rare bony tumors. Ewing sarcoma, chondrosarcoma, chordoma and osteosarcoma constitute the majority of primary bone sarcomas of the spine; however, other rare sarcoma tumors may also affect the spine. In order to perform an epidemiological study of theses tumors, national registries may help to evaluate data for populations with similar characteristics. Methods: A population-based study was designed based on data from the Iran National Cancer Registry (INCR). All morphology codes (M-Code) of primary osseous sarcomas of the mobile spine (C-code 41.2) were derived and analyzed. Results: Among 186 patients with primary osseous sarcomas of the mobile spine, 67.2% were men and 32.8% were women. The median (IQR) age was 37.0 (20.0–59.0) years and the age-standardized incidence rate (ASIR) was 0.37 per million. The majority of cases of Ewing sarcoma (29.5%) were observed in the age group 20–25 years. Among male patients with chondrosarcoma, the median age was 39.0 (30.0–50.0), while females showed a median age of 56.0 (50.0–59.0). The median age of patients with chordoma was 54.0 (47.0–63.0) years. The crude incidence rate of mobile spine osteosarcoma was 0.04 per million. Conclusion: Ewing sarcoma was the most frequent primary osseous sarcoma of the mobile spine. A male predilection was observed among all major sarcomas of the mobile spine. Ewing sarcoma in Iran affects the mobile spine in slightly older ages compared to other studies. Myxoid chondrosarcoma is the most frequent subtype of the mobile spine chondrosarcoma. Chordoma affects male in older ages compared to females. In contrast with other studies which showed a bimodal distribution of osteosarcoma of the spine including young adult and older age groups, 86% of cases in Iran were in the age group of 10–40 years.


2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Maureen I. Heaman ◽  
Patricia J. Martens ◽  
Marni D. Brownell ◽  
Mariette J. Chartier ◽  
Kellie R. Thiessen ◽  
...  

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 156.1-156
Author(s):  
E. Yen ◽  
D. Singh ◽  
M. Wu ◽  
R. Singh

Background:Premature mortality is an important way to quantify disease burden. Patients with systemic sclerosis (SSc) can die prematurely of disease, however, the premature mortality burden of SSc is unknown. The years of potential life lost (YPLL), in addition to age-standardized mortality rate (ASMR) in younger ages, can be used as measures of premature death.Objectives:To evaluate the premature mortality burden of SSc by calculating: 1) the proportions of SSc deaths as compared to deaths from all other causes (non-SSc) by age groups over time, 2) ASMR for SSc relative to non-SSc-ASMR by age groups over time, and 3) the YPLL for SSc relative to other autoimmune diseases.Methods:This is a population-based study using a national mortality database of all United States residents from 1968 through 2015, with SSc recorded as the underlying cause of death in 46,798 deaths. First, we calculated the proportions of deaths for SSc and non-SSc by age groups for each of 48 years and performed joinpoint regression trend analysis1to estimate annual percent change (APC) and average APC (AAPC) in the proportion of deaths by age. Second, we calculated ASMR for SSc and non-SSc causes and ratio of SSc-ASMR to non-SSc-ASMR by age groups for each of 48 years, and performed joinpoint analysis to estimate APC and AAPC for these measures (SSc-ASMR, non-SSc-ASMR, and SSc-ASMR/non-SSc-ASMR ratio) by age. Third, to calculate YPLL, each decedent’s age at death from a specific disease was subtracted from an arbitrary age limit of 75 years for years 2000 to 2015. The years of life lost were then added together to yield the total YPLL for each of 13 preselected autoimmune diseases.Results:23.4% of all SSc deaths as compared to 13.5% of non-SSc deaths occurred at <45 years age in 1968 (p<0.001, Chi-square test). In this age group, the proportion of annual deaths decreased more for SSc than for non-SSc causes: from 23.4% in 1968 to 5.7% in 2015 at an AAPC of -2.2% (95% CI, -2.4% to -2.0%) for SSc, and from 13.5% to 6.9% at an AAPC of -1.5% (95% CI, -1.9% to -1.1%) for non-SSc. Thus, in 2015, the proportion of SSc and non-SSc deaths at <45 year age was no longer significantly different. Consistently, SSc-ASMR decreased from 1.0 (95% CI, 0.8 to 1.2) in 1968 to 0.4 (95% CI, 0.3 to 0.5) per million persons in 2015, a cumulative decrease of 60% at an AAPC of -1.9% (95% CI, -2.5% to -1.2%) in <45 years old. The ratio of SSc-ASMR to non-SSc-ASMR also decreased in this age group (cumulative -20%, AAPC -0.3%). In <45 years old, the YPLL for SSc was 65.2 thousand years as compared to 43.2 thousand years for rheumatoid arthritis, 18.1 thousand years for dermatomyositis,146.8 thousand years for myocarditis, and 241 thousand years for type 1 diabetes.Conclusion:Mortality at younger ages (<45 years) has decreased at a higher pace for SSc than from all other causes in the United States over a 48-year period. However, SSc accounted for more years of potential life lost than rheumatoid arthritis and dermatomyositis combined. These data warrant further studies on SSc disease burden, which can be used to develop and prioritize public health programs, assess performance of changes in treatment, identify high-risk populations, and set research priorities and funding.References:[1]Yen EY….Singh RR. Ann Int Med 2017;167:777-785.Disclosure of Interests:None declared


2021 ◽  
Vol 10 (12) ◽  
pp. 2685
Author(s):  
Andre J. Burnham ◽  
Phillip A. Burnham ◽  
Edwin M. Horwitz

Olfactory neuroblastoma (ONB) is a rare neuroepithelial-derived malignancy that usually presents in the nasal cavity. The rarity of ONB has led to conflicting reports regarding associations of patient age and ONB survival and outcome. Moreover, long-term outcomes of chemotherapy and other treatment modalities are speculated. Here, we aimed to compare survival outcomes across age groups through time and determine associations between treatment modality and survival. In this retrospective population-based study, we analyzed the SEER 2000–2016 Database for patients with ONB tumors. Using Kaplan–Meier survival analysis, a significant effect of age and cancer-specific survival (CSS) was observed; geriatric ONB patients had the lowest CSS overall. Generalized linear models and survival analyses demonstrated that CSS of the pediatric patient population was similar to the geriatric group through 100 months but plateaued thereafter and was the highest of all age groups. Radiation and surgery were associated with increased CSS, while chemotherapy was associated with decreased CSS. GLM results showed that tumor grade, stage and lymph node involvement had no CSS associations with age or treatment modality. Our results provide insight for future investigations of long-term outcomes associated with ONB patient age and treatment modality, and we conclude that survival statistics of ONB patients should be analyzed in terms of trends through time rather than fixed in time.


2018 ◽  
Vol 18 (1) ◽  
pp. e97-e105 ◽  
Author(s):  
Wei Chen ◽  
Ying Huang ◽  
Gary D. Lewis ◽  
Sean S. Szeja ◽  
Sandra S. Hatch ◽  
...  

2021 ◽  
Author(s):  
Woong-Joo Whang ◽  
Jin-woo Kwon

Abstract We identify the yearly trends in the prevalence of various ocular traumas in the Republic of Korea, and the effects of Covid-19. We recorded the yearly numbers of patients diagnosed with hyphema and those who underwent open reduction surgery because of orbital blowout fracture (BOF), primary closure of the cornea or sclera (PCCS), or intraocular foreign body (IOFB) removal. The incidence of closed globe injuries has decreased significantly over the past 10 years, while that of open globe injuries has not. The patients aged ≥ 60 years showed a significant increase in BOF surgery. Regarding the trend in PCCS, while other age groups showed significant decreases, the population aged ≥ 60 years did not. In addition, the population aged ≥ 60 years showed a significant increase in the incidence of IOFB. When the 2020 data were compared with those of 2019, hyphema evidenced the largest decrease (27.02%), especially in those aged < 20 years (54.33%). In terms of both BOF and IOFB, those aged < 20 years showed the largest decreases (28.85% and 47.93% respectively). In the Covid-19 era, ocular trauma fell markedly in those aged < 20 years, perhaps because of school closures and reductions in outdoor activities.


2019 ◽  
Vol 154 (2) ◽  
pp. 338-344 ◽  
Author(s):  
Karla Willows ◽  
Rachel Kupets ◽  
Christina Diong ◽  
Danielle Vicus ◽  
Allan Covens ◽  
...  

2019 ◽  
Vol 104 (7) ◽  
pp. 994-998
Author(s):  
Ritika Mukhija ◽  
Noopur Gupta ◽  
Praveen Vashist ◽  
Radhika Tandon ◽  
Sanjeev K Gupta

ObjectiveTo characterise types of corneal diseases and resulting visual impairment (VI) in a rural North Indian population.DesignCross-sectional, population-based study.MethodsThe Corneal Opacity Rural Epidemiological study included 12 899 participants from 25 random clusters of rural Gurgaon, Haryana, India to determine the prevalence of the corneal disease in the general population. Sociodemographic details, presence and type of corneal morbidity, laterality, VI (presenting visual acuity (PVA) <6/18 in the better eye) and characteristics of corneal opacities were noted.ResultsOverall, 12 113 participants of all ages underwent detailed ophthalmic examination and prevalence of corneal opacity was found to be 3.7% (n=452) with bilateral involvement in 140 participants (31%) during the house-to-house visits. Of the total 571 eyes of 435 patients presenting with corneal opacity at the central clinic, PVA was <3/60 in 166 (29.1%), 3/60 to <6/60 in 14 (2.5%), 6/60 to <6/18 in 164 (28.7%), 6/18 to ≤6/12 in 85 (14.9%) and 6/9 to 6/6 in 142 eyes (24.9%), respectively. Further, there were a total of 115 eyes (20.1%) with nebular corneal opacity, 263 (46.1%) with macular, 162 (28.4%) with leucomatous and 31 (5.4%) with an adherent leucoma. The odds of having VI due to corneal disease were greater for the illiterate (OR:4.26; 95% CI: 2.88 to 6.31; p<0.001) and elderly (OR:11.05; 95% CI: 7.76 to 15.74; p<0.001).ConclusionThe data from this study give an insight into the characteristics of various corneal pathologies and resulting VI in the general population. This is a pioneer study involving all age groups on the burden of VI due to corneal diseases.


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