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Real-World Use of Colonoscopy in an Older Population: A Nationwide Standard Cohort Study Using a Common Data Model

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Abstract

Backgrounds and Aims

Rapid population aging is considered to be a major factor in increased colonoscopy use in Korea. However, real-world use of colonoscopy in older populations is rarely evaluated using Korean databases.

Methods

We conducted a retrospective, observational cohort study of individuals aged over 20 years between 2012 and 2017. We used the Health Insurance Review and Assessment-National Patient Samples database, previously converted to the standardized Observational Medical Outcomes Partnership-Common Data Model. The use of diagnostic colonoscopy and colonoscopic polypectomy was evaluated, stratified by age group and sex.

Results

During the study period, we captured data from the database on 240,406 patients who underwent diagnostic colonoscopy and 88,984 who underwent colonoscopic polypectomy. During the study period, use of diagnostic colonoscopy and colonoscopic polypectomy steadily increased, but both procedures were most significantly increased in the 65- to 85-year group compared to other age groups (p < 0.05). Average ages for both procedures significantly increased in the most recent 3 years (p < 0.05). Polypectomy rates for men plateaued in the 50- to 64-year age group, but rates for women steadily increased up to the 65- to 85-year group. Polypectomy rates were higher for men than for women in all index years.

Conclusions

The use of diagnostic colonoscopy and colonoscopic polypectomy significantly increased in the 65- to 85-year age group. Our findings suggest that more available colonoscopy resources should be allocated to older populations, considering the aging society in Asian countries.

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Acknowledgments

This work was supported by a grant from Kyung Hee University in 2018 (KHU-20181044).

Funding

Health Insurance Review and Assessment-National Patient Samples (HIRA-NPS) was used in this study.

Author information

Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea

    Ha Il Kim, Jin Young Yoon, Min Seob Kwak & Jae Myung Cha

  2. Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea

    Jin Young Yoon, Min Seob Kwak & Jae Myung Cha

Authors
  1. Ha Il Kim
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  2. Jin Young Yoon
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  4. Jae Myung Cha
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Contributions

HIK and JMC were involved in the study concept and design, analysis, interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content, and study supervision. MSK was involved in data management and statistical analysis. JYY was involved in data acquisition and technical support of this study.

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Correspondence to Jae Myung Cha.

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Kim, H.I., Yoon, J.Y., Kwak, M.S. et al. Real-World Use of Colonoscopy in an Older Population: A Nationwide Standard Cohort Study Using a Common Data Model. Dig Dis Sci 66, 2227–2234 (2021). https://doi.org/10.1007/s10620-020-06494-x

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  • DOI: https://doi.org/10.1007/s10620-020-06494-x

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