The Benefit of Colonoscopy

Brenna, Eiliv; Skreden, Knut; Mårvik, Ronald; Dybdahl, J. H.; Kleveland, P. M.; Sandvik, Arne K.; Halvorsen, Tore; Myrvold, H. E.; Petersen, H

doi:10.3109/00365529008999213

Cited by 35 publications

(21 citation statements)

References 28 publications

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Background: Many studies have shown that rectal bleeding is a good indicator of underlying colorectal pathology, and that ost of the lesions in patients presenting with rectal bleeding lie in the left side of the colon [1,5,9,12,23,26]. The recent acceptance of the nurse-practitioner by the National Health Service may allow the use of nurse-endoscopists to develop throughout the United Kingdom.

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confidence: 99%

“…A nurse-led OAFS is safe, effective, and acceptable to patients. It also is more cost effective than a consultantled service.Many studies [5,9,12,23,26] have shown rectal bleeding to be a good indicator of underlying colorectal pathology. It is well documented that most significant colorectal lesions are left-sided.…”

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confidence: 99%

“…It is well documented that most significant colorectal lesions are left-sided. Our initial investigation of colonoscopy [2], like other large studies [5,8,15], showed that most lesions are distal to the splenic flexure, well within the territory of the flexible scope. Again, like other studies [11,13,27], our investigation [2] showed that there is a high diagnostic yield when rectal bleeding is the presenting symptom.…”

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confidence: 99%

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Nurse-led direct access endoscopy clinics: the future?

et al. 2001

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Nurse-led direct access endoscopy clinics: the future?

et al. 2001

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“…Colonoscopy is more precise than radiology for detecting diseased mucosa because of the direct visualization of the mucosa and the possibility of taking biopsies during the procedure [23,24]. The role of colonoscopy in UC has been further substantiated with the increasing use of endoscopic endpoints for documentation of remission and response to therapy.…”

Section: Discussionmentioning

confidence: 98%

Low incidence of colorectal dysplasia and cancer among patients with ulcerative colitis: A Turkish referral centre study

Kekilli

Dağlı

Kalkan

et al. 2010

Scandinavian Journal of Gastroenterology

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“…A variety of factors have been linked to the development of adenomas or CRC (21)(22)(23)(24)(25), but currently there is no dominant risk factor that could be practically used for risk stratification in screening for neoplasia among average risk adults without known family history of CRC. Abdominal symptoms with no evidence of bleeding have been considered a poor indication for colonoscopy in series with small numbers of patients (26)(27)(28)(29). Clarification of the relative impact of these and other variables on the risk of advanced adenomas in average risk persons is needed, because such clarification might provide basis to design more efficient CRC screening strategies.…”

Section: Introductionmentioning

confidence: 99%

Use of colonoscopy as a primary screening test for colorectal cancer in average risk people*1

Betés

2003

The American Journal of Gastroenterology

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OBJECTIVEThe use of colonoscopy as a primary screening test for colorectal cancer (CRC) in average risk adults is a subject of controversy. Our primary objective was to build a predictive model based on a few simple variables that could be used as a guide for identifying average risk adults more suitable for examination with colonoscopy as a primary screening test. METHODSThe prevalence of advanced adenomas was assessed by primary screening colonoscopy in 2210 consecutive adults at least 40 yr old, without known risk factors for CRC. Age, gender, and clinical and biochemical data were compared among people without adenomas, those with nonadvanced adenomas, and those with any advanced neoplasm. A combined score to assess the risk of advanced adenomas was built with the variables selected by multiple logistic regression analysis. RESULTSNeoplastic lesions were found in 617 subjects (27.9%), including 259 with at least one neoplasm that was 10 mm or larger, villous, or with moderate-to-severe dysplasia, and 11 with invasive cancers. Advanced lesions were more frequent among men, older people, and those with a higher body mass index (BMI). These three variables were independent predictors of advanced adenomas in multivariate analysis. A score combining age, sex, and BMI was developed as a guide for identifying individuals more suitable for screening colonoscopy. CONCLUSIONSAge, gender, and BMI can be used to build a simple score to select those average risk adults who might be candidates for primary screening colonoscopy.Reprint requests and correspondence: Maria Teresa Betés Ibáñez, M.D. Departamento de Digestivo, Clínica Universitaria de Navarra 31080 Pamplona, Spain. INTRODUCTIONColorectal cancer (CRC) is the second most frequent cause of cancer-related death in western countries (1). Most cancers develop from benign adenomatous polyps (2, 3), in subjects with no known risk factors for the disease (4). Although it is not yet possible to determine which adenomas will progress to cancer, certain pathological features have been found to correlate with the risk of progressing to CRC (3, 5). "Advanced adenomas" have been defined as those with at least one of the following characteristics: size 1 cm or larger, tubulovillous or villous histology, and moderate or severe dysplasia (6-9).Screening with full colonoscopy as a primary procedure has been limited to a few small series (10-16), and results have not been focused in advanced adenomas. Two large colonoscopic series recently published (17,18) have assessed the proportion of advanced proximal adenomas in average risk adults. Although the prevalence of colonic adenomas is higher among men than among women (5,12,19,20) and increases with age (11,13,15), more data are needed to adequately assess the independent role of the most relevant predictors of advanced adenomas (18). A variety of factors have been linked to the development of adenomas or CRC (21-25), but currently there is no dominant risk factor that could be practically used for risk stratification in screening...

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The Benefit of Colonoscopy

Cited by 35 publications

References 28 publications

Nurse-led direct access endoscopy clinics: the future?

Nurse-led direct access endoscopy clinics: the future?

Low incidence of colorectal dysplasia and cancer among patients with ulcerative colitis: A Turkish referral centre study

Use of colonoscopy as a primary screening test for colorectal cancer in average risk people*1

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