Colorectal cancer is among the leading causes of cancer and cancer-related mortality in the United States. The incidence and mortality associated with CRC can be reduced with preventive screening. Inadequate bowel preparation has been associated with missed adenomas and the need for repeat colonoscopies.

We analyzed separate claims source databases to determine the costs associated with colonoscopy in the commercial and Medicare populations. We also examined observed repeat rates for colonoscopy within 4 years of initial screening were also examined.

Our findings show that though the reported rates of inadequate bowel preparation are 15% to 25%, the rates of repeat colonoscopy found in our analysis are much lower. Low repeat colonoscopy rates are a risk concern in light of the reported, significant miss rate of adenomas that is secondary to inadequate bowel preparation.