Colonoscopy in adult patients: A review of its indications and its yield in detecting colorectal neoplasia

Abstract

Objective: To review the yield and indications of colonoscopy in a surgical unit at the Prince of Wales Hospital, the result of which may help to select future patients for colonoscopy. Method: The records of 869 patients undergoing elective colonoscopy at the Prince of Wales Hospital within an 18-month period were reviewed retrospectively. Exclusion criteria included the following: a personal history of colorectal malignancy or polyps, tumours or polyps detectable on rectal examination or rigid sigmoidoscopy, a positive physical examination suggestive of gastrointestinal malignancies, anaemia or positive faecal occult blood. Results: Per rectal bleeding was the most common indication for colonoscopy. Complete colonoscopy rate was 93.7% and abnormalities were reported in 338 patients. Forty-three patients were found to have cancer whereby age, duration of symptoms, blood mixed with stool and abdominal pain were identified as independent predictive factors. Neoplastic polyps were confirmed in 200 patients. Old age and being male were the only factors predictive of neoplastic polyps. Conclusion: Although the majority of patients present with typical haemorrhoidal bleeding, colonoscopy should be considered seriously for elderly patients, especially those who are male. Chinese Abstract Figure Chinese Abstract.