U.S. GI Endoscopy Volumes: Biggest Change Is Increases in Upper Endoscopic Ultrasound

This article uses data from multiple sources to estimate gastrointestinal, liver, and pancreatic health care expenditures, ambulatory visits, and hospitalizations, as well as endoscopic procedural volumes. The estimated numbers of U.S. endoscopic procedures performed in 2019 are as follows:

• Total endoscopic procedures: 22,162,641  
• Colonoscopy: 13,837,748
• Upper endoscopy: 7,459,419
• Flexible sigmoidoscopy: 379,883
• Upper endoscopic ultrasound: 290,655
• ERCP: 177,508
• Lower endoscopic ultrasound: 17,428

Over the past 20 years, general trends have included an overall decline in colonoscopy use in persons aged 75 years or older but a gradual increase in persons aged 50 to 74 years. The overall trend in upper endoscopy use has increased slightly in most age groups. Flexible sigmoidoscopy use decreased dramatically in the first decade of this century, with fairly stable low rates since then. ERCP volumes have been generally stable across all age groups. The biggest increases in volume were in upper endoscopic ultrasound (EUS) procedures, with volumes increasing more than 6-fold in some older age groups since 2002. On the other hand, lower EUS use has declined somewhat in the past decade.