Use, appropriateness, and diagnostic yield of screening colonoscopy: an international observational study (EPAGE)

B Burnand, J Harris, V Wietlisbach, F Froehlich, JP Vader, J Gonvers, EPAGE study group, Ervin Toth

Research output: Contribution to journalArticlepeer-review

39 Citations (SciVal)

Abstract

Abstract in Undetermined
Background
Screening for colorectal cancer (CRC) has been shown to decrease mortality.

Objective
To examine determinants associated with having (1) a screening colonoscopy, (2) an appropriate indication for screening, and (3) a significant diagnosis at screening.

Design
Prospective observational study.

Setting
Twenty-one endoscopy centers from 11 countries.

Patients
Asymptomatic patients who underwent a colonoscopy for the purpose of detecting CRC and who did not have a history of polyps or CRC, a lesion observed at a recent barium enema or sigmoidoscopy, or a recent positive fecal occult blood test.

Intervention
Screening colonoscopy.

Main Outcome Measurements
Appropriateness according to the European Panel on the Appropriateness of Gastrointestinal Endoscopy (EPAGE) criteria and significant diagnoses (cancer, adenomatous polyps, new diagnoses of inflammatory bowel disease, angiodysplasia).

Results
Of 5069 colonoscopies, 561 (11%) were performed for screening purposes. Patients were more likely to have a screening colonoscopy if they were aged 45 to 54 years (odds ratio [OR] 2.53, 95% confidence interval [CI] 1.60-3.99). Screening colonoscopies were appropriate, uncertain, and inappropriate in 26%, 60%, and 14% of cases, respectively. Eighty-one significant diagnoses were made, including 4 cancers. Significant diagnoses were more often made for uncertain/appropriate indications (OR 3.20, 95% CI 1.12-9.17) than for inappropriate indications.

Limitations
Although data completeness was asked of all centers, it is possible that not all consecutive patients were included. Participating centers were a convenience sample and thus may not be representative.

Conclusions
About 1 of 10 colonoscopies were performed for screening, preferentially in middle-aged individuals. A higher diagnostic yield in uncertain/appropriate indications suggests that the use of appropriateness criteria may enhance the efficient use of colonoscopy for screening.
Original languageEnglish
Pages (from-to)1018-1026
JournalGastrointestinal Endoscopy
Volume63
Issue number7
DOIs
Publication statusPublished - 2006

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Medical Radiology Unit (013241410), Emergency medicine/Medicine/Surgery (013240200)

Subject classification (UKÄ)

  • Radiology, Nuclear Medicine and Medical Imaging
  • Clinical Medicine

Fingerprint

Dive into the research topics of 'Use, appropriateness, and diagnostic yield of screening colonoscopy: an international observational study (EPAGE)'. Together they form a unique fingerprint.

Cite this