Colonoscopy in the very elderly: a review of 157 cases
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Colonoscopy is currently the best diagnostic modality for evaluating colonic diseases but studies of its use in the very elderly are limited.
A single-institution review of all patients aged 85 years or older who underwent colonoscopy from June 2003 to June 2005 was performed. Parameters evaluated included indications for colonoscopy, findings, ability to perform a complete colonoscopy, and immediate and delayed (≤21 days) complications.
A total of 157 patients aged 85 years or older (median = 87, range = 85–99) underwent colonoscopy during the two-year period. The cecal intubation rate was 90%. Number of cancers detected/indications for colonoscopy include gross or occult bleeding per rectum, 3/51 (5.9%); abnormal physical exam, 1/2 (50%); abnormal abdominal computed tomography, 3/5 (60%); anemia, 1/25 (4.0%); screening, 0/14; previous history of colonic malignancy, 0/10; previous history of polyps, 0/21; change in bowel habits, 0/5; family history of colonic malignancy, 0/6; abdominal pain, 0/4; diarrhea, 0/6; fecal impaction, 0/2; unknown, 0/6. Immediate complications included hemorrhage at a polypectomy site in one patient that was controlled endoscopically, one episode of bradycardia, and one incident of atrial fibrillation. There were no delayed complications resulting from colonoscopy.
Our data suggest that colonoscopy can be safely and successfully performed in the very elderly. In patients with symptoms or suggestive radiographic findings, cancer was detected in 4.0%–60% of cases. No cases of cancer were discovered in those patients who were asymptomatic.
KeywordsColorectal cancer Colonoscopy Elderly
- 1.American Joint Committee on Cancer (AJCC) (2002) Colon and Rectum. In: AJCC Cancer Staging Manual, 6th ed. Springer, New York, pp 113–124Google Scholar
- 3.Center for Disease Control and Prevention (CDCP) (2006) National Center for Health Statistics. Health, United States, 2006. With Chartbook on Trends in the Health of Americans. Table 27. Hyattsville, MDGoogle Scholar
- 4.DEVCAN Software (2005) Probability of Developing or Dying of Cancer, Version 5.2. Statistical Research and Applications Branch, National Cancer Institute. Available at: http://www.srab.cancer.gov/devcan. Cited Dec 2006
- 19.Ure T, Dehghan K, Vernava AM 3rd, Longo WE, Andrus CA, Daniel GL (1995) Colonoscopy in the elderly. Low risk, high yield. Surg Endosc 9: 505–508Google Scholar
- 20.U.S. Census Bureau (1993) Population Projections of the United States, by Age, Sex, Race, and Hispanic Origin: 1993 to 2050, Current Population Reports, P25-1104, U.S. Government Printing Office, Washington, DCGoogle Scholar
- 21.U.S. Census Bureau (2004) Estimates of the Resident Population by Selected Age Groups for the United States and for Puerto Rico, SC-EST2004-01-RES. U.S. Government Printing Office, Washington, DCGoogle Scholar
- 25.Winawer S, Fletcher R, Rex D, Bond J, Burt R, Ferrucci J, Ganiats T, Levin T, Woolf S, Johnson D, Kirk L, Litin S, Simmang C (2003) Colorectal cancer screening and surveillance: clinical guidelines and rationale. Update based on new evidence. Gastroenterology 124: 544–560Google Scholar
- 26.Winawer SJ, Zauber AG, Ho MN, O’Brien MJ, Gottlieb LS, Sternberg SS, Waye JD, Schapiro M, Bond JH, Panish JF, et al. (1993) Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med 329: 1977–1981Google Scholar