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Impact of the Aging Population on the Demand for Colorectal Procedures

Etzioni, David A. M.D., M.S.H.S.1,2,3; Beart, Robert W. Jr M.D.1; Madoff, Robert D. M.D.4; Ault, Glenn T. M.D., M.S.Ed.1

Diseases of the Colon & Rectum: April 2009 - Volume 52 - Issue 4 - p 583-590
doi: 10.1007/DCR.0b013e3181a1d183
Original Contributions

PURPOSE: With the baby boomers entering retirement age, the United States population is seeing a dramatic increase in the number of elderly individuals. We hypothesized that as a result, during the next 20 years, the demand for colorectal procedures will grow rapidly.

METHODS: We used the 2005 Nationwide Inpatient Sample and the Florida State Ambulatory Surgery Database as source data. From these two data sources, we identified commonly performed inpatient and outpatient colorectal procedures, as well as associated diagnoses. These data were combined with census projections to generate projected volumes for the selected procedures and diagnoses.

RESULTS: Between 2005 and 2025, the United States population is expected to grow by 18 percent, with disproportionate growth in individuals aged 65 to 74 years (92 percent) and those aged 75+ years (54 percent). We forecast that growth in outpatient procedures and inpatient procedures will be 21.3 percent and 40.6 percent, respectively. Inpatient operations for colon cancer and rectal cancer show the greatest growth.

CONCLUSIONS: During the next two decades, demographic changes in the United States population will lead to a marked increase in the use of colorectal surgical services, especially inpatient and oncologic procedures. The ability of the surgical workforce to meet this projected growth in demand should be assessed.

1 Department of Colorectal Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California

2 Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California

3 RAND Health, Santa Monica, California

4 Department of Surgery, University of Minnesota, Minneapolis, Minnesota

Address of correspondence: David A. Etzioni, M.D., M.S.H.S., Department of Colorectal Surgery, University of Southern California, Keck School of Medicine, 1441 Eastlake Avenue, Suite 7418, Los Angeles, California 90033. E-mail:

© The ASCRS 2009