To the Editor The Research Letter by Dr Riggs and colleagues evaluated the prevalence of office visits prior to colonoscopy for colorectal cancer screening.1 They found that 30% of colonoscopies were preceded by a gastroenterology office visit, which added a mean of $36 per colonoscopy distributed across all patients. The authors were concerned that this result may point to potential waste of resources given that it is possible to refer for screening colonoscopy without a gastroenterology visit. We are concerned that, despite their best efforts to include the appropriate patients on the basis of claims, there are enough confounders to question the validity of their findings.
Leow JJ, Trinh QD, McNabb-Baltar J. Office Visits Prior to Screening Colonoscopy. JAMA. 2016;315(24):2734. doi:10.1001/jama.2016.4289