Outcome of colonoscopy in elderly African-american patients

Background: Average-risk individuals should be offered a screening colonoscopy beginning at 50 years of age. However, there is no clear consensus on an age at which patients should no longer be offered a screening colonoscopy. The purpose of this study was to analyze the outcome of colonoscopy in elderly individuals based on the preprocedure indication. Methods: A retrospective chart review was performed of all patients who underwent colonoscopy at Howard University Hospital from Jan 1, 2001 to Dec 31, 2005. Patients older than age 75 years were then stratified into two groups: one group classified as average risk for colon cancer and a second group classified as higher risk for finding cancer based on indication. Significant findings from colonoscopy were assigned if the patient was found to have an advanced adenoma, such as villous attributes, high-grade dysplasia, adenoma ≥1 cm, or cancer. All others findings at colonoscopy were categorized as having nonsignificant findings. Results: During this period, 922 elderly patients (75 years of age or older) underwent colonoscopy. Based on preprocedure indications, 606 patients were considered higher risk and 316 average risk. Among the preprocedure higher-risk patients, 532 had nonsignificant findings include hemorrhoids, diverticulosis, telangiectasias, lipomas, and inflammatory polyps. Among the preprocedure average-risk patients, 286 had nonsignificant findings. From the 110 patients who underwent screening colonoscopy, 99 patients had nonsignificant findings. Malignancy was found in 42 patients: 33 who had higher-risk indications and 9 who had average-risk indications. Conclusion: Average-risk patients are less likely to have significant findings, including cancer, on colonoscopy.