Colonoscopy in elderly should be limited to patients with symptoms or specific clinical findings
Researchers recommended that colonoscopy in the elderly be limited patients with symptoms or specific clinical findings.
"Current colonoscopy guidelines do not address the issue of when to stop performing screening and surveillance colonoscopy in the elderly. We reviewed our experience and results of colonoscopy in patients aged 80 years and older to assess the risks and diagnostic yield in this population. We reviewed retrospectively the endoscopic and pathologic reports from consecutive colonoscopies performed on patients aged 80 years and older at a single, high-volume endoscopy center between August 1999 and May 2003," investigators in the United States reported.
"Patient characteristics, indications for examination, findings at colonoscopy, and complications were recorded and analyzed," explained J.E. Duncan and colleagues, University of Minnesota. "A total of 1,199 colonoscopic examinations were performed on 1,112 patients. Average age was 83.1 (range, 80-100) years. Male:female distribution was 1:1.7. Leading exclusive indications for colonoscopy included: polyp surveillance, 227 (19%); altered bowel habits, 168 (14%); iron-deficiency anemia, 132 (11%); and cancer follow-up, 108 (9%).
"Eighty-six examinations (7%) were performed solely for an indication of colorectal cancer screening. Twenty-two percent of patients had more than one indication for colonoscopy. Forty-five malignancies were found (3.7%). No cancers were found in the screening group, and 2 malignancies (0.7%) were detected in patients undergoing colonoscopy for polyp surveillance. There were 8 (0.6%) reported major complications. Colonoscopy can be performed safely in patients aged 80 years and older. However, the diagnostic yield is low, particularly in patients undergoing routine screening or surveillance examinations."
The researchers concluded, "Colonoscopy should for the most part be limited to elderly patients with symptoms or specific clinical findings."
Duncan and colleagues published their study in Diseases of the Colon & Rectum (Colonoscopy in the elderly: Low risk, low yield in asymptomatic patients. Dis Colon Rectum, 2006;49(5):646-651).
For additional information, contact W.B. Sweeney, University of Minnesota, Dept. of Surgery, Division Colon & Rectal Surgery, 393 Dunlap St. N, Suite 500, St. Paul, MN 55104, USA.
The publisher of the journal Diseases of the Colon & Rectum can be contacted at: Springer, 233 Spring Street, New York, NY 10013, USA.
Keywords: St Paul, Minnesota, United States, Colon Cancer Screening, Colon Carcinoma, Colonoscopy, Colorectal Cancer, Diagnostics, Elderly, Gastroenterology, Geriatrics, Hematology, Iron Deficiency, Oncology, Rectal Cancer, Rectal Carcinoma.
This article was prepared by Medical Imaging Week editors from staff and other reports. Copyright 2006, Medical Imaging Week via NewsRx.com.