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Colonoscopy in the very old: why bother?
1Department of Gastroenterology, Kingston Hospital NHS Trust, Galsworthy Road, Kingston upon Thames KT2 7QB, UK. k_y_yoong@hotmail.com
Postgraduate Medical Journal
|March 8, 2005
Summary
Colonoscopy is valuable for patients over 85, detecting polyps and malignancy with few complications. Age alone should not prevent this important diagnostic procedure.
Area of Science:
- Gastroenterology
- Geriatric Medicine
- Diagnostic Procedures
Background:
- Colonoscopy is a key diagnostic tool for lower gastrointestinal symptoms.
- The utility and safety of colonoscopy in very elderly patients (≥85 years) require evaluation.
- Ensuring age-inclusive healthcare services is an important consideration.
Purpose of the Study:
- To assess the efficacy and outcomes of colonoscopy in patients aged 85 years and older.
- To determine if colonoscopy provides significant diagnostic yield in this specific demographic.
- To evaluate whether ageism impacts access to this procedure.
Main Methods:
- A retrospective audit was conducted.
- Data were collected from patients aged 85 years and above who underwent colonoscopy over a five-year period.
- Indications, findings, and outcomes, particularly for colonic cancers, were analyzed.
Main Results:
- Colonoscopy was successfully completed in 69% of cases, with poor bowel preparation and diverticular disease being primary reasons for failure.
- A causative finding was identified in 37% of patients.
- Polyps were detected in 14.2% and malignancy in 8.8% of cases.
Conclusions:
- Colonoscopy demonstrates significant diagnostic value in patients aged 85 and older, with a notable yield for polyps and malignancies.
- The procedure was associated with minimal complications in this age group.
- Increasing age should not be a barrier to undergoing colonoscopy.