COLONOSCOPY IN ELDERLY AND YOUNG SUBJECTS:WHAT INDICATIONS ARE ASSOCIATED WITH HIGH-RISK LESIONS FOR COLORECTAL NEOPLASIA?

Aims The indications for colonoscopy are clearly defined, with an essential role in etiological diagnosis, including colorectal cancer screening. Common indications for young adults under 50years include rectorrhagia and diarrhea, whereas for subjects over50 years the indications may be broader given the risk of colorectal cancer.

The aim of our study is to compare the indications and results of colonoscopy between those under and over 50years, and to determine the indications associated with a risk of neoplastic lesions.

Methods This is a retrospective study over a period of 3.5years, including1518 patients who underwent colonoscopy. The patients were divided into 2 groups: groupA under 50years, groupB over 50years . Patients with known inflammatory bowel disease(IBD) were excluded from our study.

Results 65.1% of the patients were over 50years old and 34.9% under 50years old. Indications for colonoscopy were dominated by constipation in group B29.1% (vs 22%;p=0.01), and by diarrhea in group A33.3% (vs19.3%; p<0.001).Colonoscopy was pathological in49.1% of patients in group B vs32.9% of patients in group A(p<0.001),dominated by colitis or rectocolitis(47.9%) in subjects under 50years of age(vs 11.7%; p<0.001),polyps(61.5%vs 41.3%; p<0.001) and colorectal neoplasia(16%vs 5%; p=0.002) in older subjects.The indications associated with a higher risk of neoplastic lesions were constipation in subjects<50years(p=0.007) and rectal bleeding and constipation(p<0.001) in subjects>50years.

Conclusions The presence of colorectal neoplastic lesions was strongly associated with the presence of constipation in subjects<50years and with both rectorrhagia and constipation in subjects>50years.Determining these indications in more studies may help to improve the appropriateness of colonoscopy mainly in younger people.

 

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Publication History

Article published online:
14 April 2022