Availability and Distribution of Endoscopists in Chile: The First National Survey and the Need for Comparative Data in Latin America
Abstract:
Background: Gastric and colorectal cancers remain major causes of morbidity and mortality in Chile and world wide, and their prognosis largely depends on early diagnosis. Digestive endoscopy is the main tool for detecting preneoplastic lesions and early-stage neoplasms. However, Chile lacks a national endoscopic screening program, and the actual availability of endoscopists is not precisely known, making it difficult to assess the feasibility of popu lation-based screening strategies.
Objective: To characterize the number, geographic distribution, and professional training of medical endoscopists in Chile, in order to identify gaps relative to international standards and to estimate human resource needs for future screening programs.
Methods: An observational, descriptive, cross-sectional study based on a digital survey applied to physicians per forming upper gastrointestinal endoscopy and/or colonoscopy in public and private healthcare centers. Information was triangulated with institutional directories and endoscopic equipment suppliers to validate estimates of the total number of specialists. Data were analyzed using descriptive statistics and contextualized with preliminary census population data (INE 2024).
Results: Of an estimated total of 641 endoscopists, 453 valid surveys were obtained. The estimated national rate was 32.3 endoscopists per million inhabitants, with marked geographic disparities: the lowest rates were observed in Tarapacá and Maule, and the highest in the Metropolitan Region, Aysén, and Magallanes. Overall, 51.7% of physi cians worked in both the public and private sectors, while 17.9% worked exclusively in the public sector. Regarding training, 82.6% reported formal subspecialty training, mainly in adult gastroenterology.
Conclusions: Chile has an insufficient and territorially uneven supply of digestive endoscopists, which hinders the implementation of screening programs comparable to international models. Public policies are needed to establish a national registry, expand and standardize training, promote equitable redistribution of human resources, and assess the feasibility of endoscopic screening programs. These measures are essential to strengthen early detection and re duce the burden of digestive cancers in the country.
