In Reply Dr Leow and colleagues raise several important considerations. We agree that the primary finding of our study—that among patients aged 50 to 64 years with private health insurance, nearly 30% who underwent a colonoscopy for colon cancer screening or polyp surveillance had an office visit with gastroenterology in the preceding 6 weeks—may not be generalizable to groups not represented in the cohort, particularly to people aged 65 years and older or with Medicaid. However, the majority of individuals aged 50 to 64 years have private health insurance,1 so the results are informative in this age group for whom colon cancer screening is an important consideration.
Riggs KR, Shin EJ, Segal JB. Office Visits Prior to Screening Colonoscopy—Reply. JAMA. 2016;315(24):2734-2735. doi:10.1001/jama.2016.4298