However, serious cardiopulmonary events were the most common major events. Long-term programmatic screening and surveillance was safe, as major events were rare during follow-up. History of prior colonoscopic adverse events was associated with increased risk of events (major or minor) during follow-up (OR, 2.7 95% confidence interval, 1.6-4.6). Examinations with major events included 1 perforation, 3 GI bleeds requiring intervention, and 17 cardiopulmonary events. Incidence of major events (per 1000 examinations) remained relatively stable over time, with 6.1 events at examination 2, 4.8 at examination 3, and 7.2 at examination 4. Of 3727 follow-up examinations in 1983 participants, adverse events occurred in 105 examinations (2.8%) in 93 individuals, including 22 major and 87 minor events (examinations may have had >1 event). Multivariable odds ratios (ORs) were calculated for factors associated with risk of follow-up adverse events. Periprocedure adverse events requiring significant intervention were defined as major events (other events were minor) and were tracked during follow-up for at least 10 years. 380 includes 3121 asymptomatic veterans aged 50 to 75 years who underwent screening colonoscopy between 19. We aimed to describe adverse events during follow-up in a colonoscopy screening program after the baseline examination and examine factors associated with increased risk.Ĭooperative Studies Program no. Ewing, MD, Minneapolis Georgeĭata are limited regarding colonoscopy risk during long-term, programmatic colorectal cancer screening and follow-up. Campbell, MD, Kansas City, MO Theodore E. Schnell, MD, and Gregorio Chejfec, MD, Hines, IL Donald R. The authors also acknowledge other VA Cooperative Study Group 380 investigators: William V. The authors acknowledge Veterans Affairs Cooperative Studies Program 380, Grant Huang, PhD MPH, Director. Participants with baseline CRC, advanced adenomas, or 3+ small adenomas remained at increased risk for AN over 10 years when compared with Acknowledgments Using rigorous methods to acquire detailed data from a CRC screening cohort of asymptomatic individuals undergoing surveillance, we found strong evidence that baseline screening colonoscopy findings remain highly predictive of outcomes during the 10-year follow-up period, even after accounting for varying intensity of surveillance and other CRC risk factors. 21 Over 10 years of surveillance, 1915 (61.3%) Discussion The adenoma detection rate was 37.8% and the polyp detection rate was 54.0%. At baseline, the cecal intubation rate, assessed by photo documentation, was 97.7%. Although there were no quality metrics for colonoscopy at that time, CSP #380 developed metrics, recognizing that the quality of colonoscopy could impact both screening and surveillance outcomes. 21 The initial inclusion criteria included only VA participants with no previous structural colon examinations and no history of lower ResultsĪt baseline, 3121 subjects were enrolled and had screening colonoscopy from 1994 to 1997. The complete methods of CSP #380 were previously reported and are summarized here. Biopsy was done in 39.51% patients and the most common finding was nonspecific inflammatory bowel disease, 36.08% had adenocarcinomas and rest had ulcerative colitis, juvenile and hamartomatous polyps.Ĭonclusion: Colonoscopy is a safe and effective investigation in diagnosing as well as managing the patients with LGI symptoms.In the prospective Department of Veterans Affairs (VA) Cooperative Studies Program Study #380 (CSP #380), 3121 asymptomatic veterans aged 50 to 75 underwent a screening colonoscopy between 19 across 13 VA medical centers and were then followed for 10 years. Haemorrhoids (27.34%) were the most common findings and then nonspecific inflammatory bowel diseases (17.55%), colorectal polyps (15.51%) and colorectal cancers (14.28%). In 85.71% patients entire large bowel could be visualized. The common indications were per rectal bleeding (49.38%), alteration in bowel habit (40.49%), and constipation (13.46%). The youngest patient undergoing colonoscopy was 21 and the eldest was 78 with the mean age being 53.6☑2. Results: 245 patients underwent colonoscopy, among them 62.85% were male and 37.14% were female with the M:F ratio being 1.6:1. Methods: This was an observational, hospital based study from February 2014 to March 2018, carried out at Nepalgunj Medical College and Teaching Hospital. This study was done to evaluate the role of colonoscopy. Colonoscopy is a low risk and at the same time investigation of choice in these patients which allows visualization of the entire colon and the terminal portion of ileum. Nepalgunj Medical College & Teaching Hospital, Nepalgunj, Banke, NepalĬolonoscopy, bleeding per rectum, haemorrhoids, biopsy Abstractīackground: About 30% of patients presenting to surgical outpatient department has lower gastrointestinal (LGI) symptoms.
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6/19/2023 04:32:38 am
That baseline screening colonoscopy results continue to be highly predictive of outcomes over the 10-year follow-up period is supported by excellent data, as you noted. My relative says she has a strange feeling in her stomach. I'll advise her to undergo a colonoscopy to look for signs.
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