title: Acceptance and outcome of endoscopic screening for colonic neoplasia in patients undergoing clinical rehabilitation for gastrointestinal and metabolic diseases.
abstract: Our purpose was to study the acceptance and the outcome of endoscopic screening investigations of the colon in patients between 50 and 60 years of age in a clinical rehabilitation center. A total of 1,166 patients (m = 691, f = 475) entered the study. After guaiac testing all patients for fecal occult blood loss (FOBT), 667 patients (57%; m = 407, 61%; f = 260, 39%; n.s.) accepted a sigmoidoscopy. Of 658 (m = 403, f = 255) patients with complete investigation, 153 (23%) (m = 104, 26%; f = 49, 19%; n.s.) had a total of 272 neoplastic polyps, including 1 carcinoma. Adenomas = /> 10 mm were found exclusively in male patients (n = 25, p < 0.001). In comparing patients aged 50-55 years (n = 386) with those aged 56-60 years (n = 272), prevalences of neoplasia were found to be 19%/29% (p < 0.01), and prevalences of adenomas = /> 10 mm were 2%/10% (p < 0.05). The acceptance of a colonoscopy in patients with neoplastic polyps at sigmoidoscopy was 116/153 (m = 78, 75%; f = 38, 78%; n.s.). In 39 of these patients (34%) (m = 31, 40%; f = 8, 21%; p < 0.05), 68 further adenomas were detected but no carcinoma or adenoma with severe dysplasia. Multiple adenomas in the proximal colon were seen in 17 cases (15%) (m = 16, 21%; f = 1.3%; p < 0.01). The FOBT was positive in 10/658 patients, including the case with a carcinoma, but only in 4/25 with adenomas = /> 10 mm. In 5 cases with positive FOBT sigmoidoscopy and complementary colonoscopy did not reveal any pathology.
authors.affiliation: Marbachtalklinik, Bad Kissingen.
authors.forename: U
authors.initials: U
authors.lastname: Armbrecht
authors.forename: B
authors.initials: B
authors.lastname: Manus
authors.forename: R
authors.initials: R
authors.lastname: Brägelmann
authors.forename: R W
authors.initials: RW
authors.lastname: Stockbrügger
authors.forename: M
authors.initials: M
authors.lastname: Stolte
mesh_terms: D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D003111:Colonic Polyps / Q000453:epidemiology / Q000517:prevention & control; D003113:Colonoscopy; D003430:Cross-Sectional Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000534:rehabilitation*; D006801:Humans; D015994:Incidence; D007861:Lebanon; D008297:Male; D008403:Mass Screening; D008659:Metabolic Diseases / Q000453:epidemiology / Q000534:rehabilitation*; D008875:Middle Aged; D009780:Occult Blood; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D012047:Rehabilitation Centers; D012812:Sigmoidoscopy