Background Colorectal cancer (CRC) is the third most common cancer among men, and the second among women worldwide. In Brazil, the incidence and mortality of CRC continues to increase. In colonoscopies, adenoma detection rates (ADRs) higher than 25% are associated linearly with better outcomes and lower rates of interval cancer. Objective To assess the colonoscopy quality indexes. Methods This is a cross-sectional retrospective study in which anatomopathological data and data regarding the colonoscopies were collected from the patient records of Hospital Moinhos de Vento, in Southern Brazil. The exams were performed by doctors from the Colorectal Service from June to August 2015. Results A total of 430 exams were included. Most patients were women (60.9% [262]), with a mean age of 56.96 years. The cecal intubation rate was of 96.7% (416). The quality of the bowel preparation was excellent or good in 92.95% (396) of the cases. The average time of removal of the colonoscope in normal exams was of 6.15 minutes. Polyps were detected in 201 patients (46.7%), and adenomas, in 125 patients (29.1%); 12 patients (2.8%) had advanced adenomas, and 6 (2.3%) had malignant neoplasms. The proximal serrated lesion detection rate (PSLDR) was of 6.7% (29). The prevalence ratio (PR) of adenomas among men was 1.78 times greater than in women (95% confidence interval [95%CI]: 1.16–2.75). The PR of adenomas among people aged 50 years or older was 2.41 times that of those under 50 years of age (95%CI: 1.43–4.06). Conclusion The data obtained are in line with international quality criteria in colonoscopy. More studies are needed to assess the ADR in the Brazilian population.
role in reducing CRC incidence and mortality. In medium-risk individuals, the initiation of screening starts at 45 or 50 years, and is discouraged after 76 years, due to low life expectancy, comorbidities and increased number of complications. Among well-known risk factors for colorectal cancer, age has a preeminent role. Incidence rises as people become older. On the other hand in recent decades we are watching the improved life expectancy with an increase in the population's mean age in the developed countries, and a consequent higher number of senior citizens. Aim: Our purpose was to to evaluate the prevalence of advanced adenomas (ie, adenoma >10 mm, villous adenoma, adenoma with high-grade dysplasia, or invasive cancer) and malignant lesions of the colon in very elderly patients (> 80 years) who would not be eligible for CRC screening and surveillance in the current Concensus. The intention is to demonstrate that due to increased longevity, screening in very elderly patients should not be generally discouraged, but individualized according to the clinical condition of each patient. Patients & Methods: Retrospective cross-sectional study of data collection from medical records of patients aged 80 years who underwent colonoscopy at the Gastrointestinal Endoscopy Service of Hospital 9 de Julho, in São Paulo (Brazil), from January to December / 2018. Examinations in which there was no resection of lesions due to contraindication were excluded. Results: Were evaluated medical records of 202 colonoscopies performed in patients aged 80 to 101 years (mean 84), 111 (54.9%) female and 91 (45%) male; 49 (24.25%) with indication for CCR screening, 56 (27.72%) surveillance and 97 (48.01%) diagnostic investigation. All examinations were performed with in-hospital preparation and under anesthetic assistance. Of the 202 colonoscopies, 119 (58.91%) showed lesions, including 95 (79.83%) adenomas, and 47 (39.49%) adenomas with advanced characteristics; 06 (5.04%) large serrated lesions larger than 1.0 cm and 06 (5.04%) advanced adenocarcinomas. Of the 119 patients with lesions, 32 (27%) had already undergone previous colonoscopy whereas 87 (73%) were undergoing the examination for the first time (p <0.0001 (95% Cl: 33.83 to 56, 13%). Conclusion: In our sample, patients aged 80 years who would not necessarily be included in screening and surveillance programs had a prevalence of 58.91% colonic lesions and 44.53% of premalignant lesions (advanced adenomas). and large serrated lesions), as well as 6 advanced adenocarcinomas (2.9%). These lesions were significantly more prevalent in patients who had never undergone a previous colonoscopy examination.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.