YIELD OF COLONOSCOPY IN YOUNG PATIENTS: A MONOCENTRIC STUDY

Aims:

Despite a low risk of complications, colonoscopy is an invasive procedure. Therefore, it is important to select the indications and to use this procedure in patients in whom it yields an important diagnosis, without missing pathology in others.

Aim: to determine the clinical and biological criteria that can be used to identify the patients up to 40 years, in whom coloscopy should be indicated.

Methods:

A monocenter retrospective study was conducted from january 2016 to march 2017 including colonoscopies performed in patients 40 years old and younger. According to the indications for colonoscopy, 2 groups were defined:

• Group 1: patients with clear indications for colonoscopy: rectal bleeding, iron deficiency anaemia, and strong family history of colorectal cancer.

• Group 2: patients with relative indications: abdominal pain or discomfort, bloating and altered bowel habit.

Results:

One hundred and twenty coloscopies were included. Mean age was 30.7 years (17 – 39 years). The sex ratio was 0.81 (M/F = 54/66). Eighty five patients had clear indications (associated or not to relative indications) and 35 only relative indications. Altogether, 96 colonoscopies (80%) were normal, 14 (11.6%) showed inflammatory bowel disease and 8 revealed hemorrhoids (6.6%). Two patients with a family history of familial adenomatous polyposis had polyps. No subject with only relative indications had an abnormal finding (0/35, 0% vs. 24/85, 28.2%) (p < 0.001).

Conclusions:

Our study showed that colonoscopy is not appropriate in young patients with only relative indications. These results should be confirmed by much larger, multicenter and prospective studies.