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The benefit of colonoscopy
E Brenna1, K Skreden, H L Waldum
1Dept. of Medicine, Trondheim Regional and University Hospital, Norway.
Scandinavian Journal of Gastroenterology
|January 1, 1990
Summary
Colonoscopy is beneficial for diagnosing significant abnormalities, especially for rectal bleeding indications. However, predicting findings remains challenging, with 39% disagreement between predictions and actual colonoscopy results.
Area of Science:
- Gastroenterology
- Diagnostic Endoscopy
- Colorectal Cancer Screening
Background:
- Colonoscopy is a key tool for diagnosing colorectal conditions.
- Predictive accuracy of endoscopic findings can impact clinical decision-making.
- Understanding the benefits across different indications is crucial for optimizing patient care.
Purpose of the Study:
- To evaluate the diagnostic yield of colonoscopy based on predicted versus actual findings.
- To compare the accuracy of predictions across various indications for the procedure.
- To characterize the clinical significance of findings and therapeutic interventions during colonoscopy.
Main Methods:
- Prospective study of 833 consecutive outpatient and open-access colonoscopies.
- Endoscopists predicted findings before each procedure.
- Comparison of predicted versus actual colonoscopic findings and indications.
Main Results:
- Overall agreement between predicted and actual findings was 61%.
- Clinically significant abnormalities were detected in approximately 50% of examinations.
- Most frequent findings included benign polyps (24%), inflammatory bowel disease (17%), and malignancy (5%).
- Malignancies were often unpredicted (50%) and frequently associated with rectal bleeding indications.
Conclusions:
- Colonoscopy demonstrates significant diagnostic benefit, particularly for patients with rectal bleeding or abnormal prior imaging.
- Predictive accuracy for endoscopic findings requires improvement.
- Complete colonoscopy is vital for patients undergoing surgery for colorectal carcinoma.