UICC World Cancer Congress 2006

Methods: Insurers submit billing information to the Maryland Health Care Commission (MHCC) Medical Care Data Base (MCDB). MHCC compiles these data with Medicare and Medicaid data. For datasets covering procedures from 1999-2002, we analyzed the number of colonoscopies and sigmoidoscopies among Maryland residents by date, age group, county of residence, and type of insurance and calculated rates of procedures.

Results: The number of colonoscopies reportedly performed on Maryland residents increased from 62,938 in 1999 to 138,958 in 2002 (220% increase). During this same time, the number of sigmoidoscopies in the same population fell from 29,414 to 8,865. Annual rates of colonoscopy of those 65+ who had utilized Medicare services went from 7.3% to 10.0%; whereas, sigmoidoscopy rates fell from 1.9% to .9%. Rates of colonoscopy in Baltimore City were approximately equal to rates in the remainder of the state among the insured, but were lower than the remainder of Maryland when census population denominators were used to calculate rates.

The magnitude of the increase in colonoscopy rates and numbers of colonoscopies from the MHCC data was similar to increases found in population-based survey data (Maryland Cancer Survey and BRFSS). MCDB is a useful for documenting trends in screening for the insured population and for comparing to other indicator surveys such as the Study of Endoscopic Capacity (SECAP).