One in three adults above 50 years old have not been screened for colorectal cancer as of 2013.¹ Rural areas have even lower screening and have more general surgeons compared to gastroenterologists,² offering surgeons as a reservoir for necessary services.

Public data from the 2006–2015 CDC National Ambulatory Medical Care Survey was analyzed using SAS. Number of colonoscopies performed by rural general surgeons, family medicine practitioners, and other specialties were compared to their urban counterparts.

21.91% of rural colonoscopies were performed by general surgeons, whereas 32.87% were performed by family medicine practitioners and 45.22% by other specialties including gastroenterologists. Rural general surgeons performed a greater percentage of annual rural colonoscopies than urban general surgeons (p < 0.05).

General surgeons are fulfilling the need for colonoscopy in rural areas. Improvements to current colonoscopy training guidelines are imperative, especially for physicians who practice in rural areas.

Summary: Colonoscopies are the most sensitive and specific screening method for colorectal cancer, yet there is a deficit in screening in the United States that disproportionately affects patients in rural communities. Studies show that much of rural general surgery practice consists of endoscopic procedures. Using data recorded by the National Ambulatory Medical Care Survey (NAMCS), we found that rural general surgeons perform more colonoscopies than other rural providers, and a greater percentage of annual rural procedures than urban general surgeons. We conclude that general surgeons are filling the unmet need for colonoscopies in rural communities, therefore it is important to ensure surgery programs adequately train residents to confidently perform these procedures.