DDW: Colonoscopy Timing Affects Carcinoma Detection in Elderly
(HealthDay News) – Although the majority of outpatient colonoscopy exams among elderly patients reveal insignificant findings, the timing of the most recent colonoscopy impacts the rate of carcinoma detection.
To investigate cancer detection rates for the elderly undergoing outpatient colonoscopy, Therese Kerwel, MD, from Grand Rapids Medical Education Partners in Michigan, and colleagues reviewed data from 903 outpatient examinations in patients aged 76–85 years, during 2009 and 2010.
The researchers found that exams were normal or insignificant polyps were seen in 70.3% of colonoscopies, with a detection rate of 2.3% for carcinomas and 23.8% for adenomas. The carcinoma detection rate was 9.4% for patients undergoing colonoscopy for the first time (P=0.01, compared with those who had undergone previous colonoscopy) and 5.4% for those who had undergone colonoscopy more than 10 years previously. A 2.8 or 0% carcinoma detection rate was seen for those who underwent repeat colonoscopy less than three years ago or four to five years ago, respectively. On stratification by indication, anemia yielded the highest rate of carcinoma detection (3.9%), followed by gastrointestinal blood loss (3.3%).
"Further guidelines designed to efficiently utilize resources should focus on minimizing redundant exams unlikely to yield significant results while supporting screening exams with high yield," the authors write.
One author disclosed financial ties to Myriad Genetic Laboratories Inc.