title: Diagnostic yield of screening colonoscopies in lung transplant candidates.
abstract: BACKGROUND
  Colonoscopy has been used to screen lung transplant candidates for colorectal diseases that would preclude transplantation. The diagnostic yield of this procedure is unknown.
  
  
  METHODS
  This is a retrospective cohort study of patients 50 years of age and over who underwent lung transplant evaluations from 1996 to 1999. We assessed the prevalence and location of colonoscopic abnormalities, the predictive value of risk factors for colonic neoplasms, and the impact of colonoscopic findings on management.
  
  
  RESULTS
  Thirty-one patients were evaluated. Twenty-four patients had at least one abnormal endoscopic finding. Six patients (19%) had adenomatous polyps; no carcinomas were detected. The 13 patients with risk factors were more likely to have adenomas (relative risk=2.8, P=0.2). The negative predictive value of risk factors for adenomas was 89%. One patient's management was altered and none were denied transplant listing because of the colonoscopic findings.
  
  
  CONCLUSIONS
  Screening colonoscopy did not substantively alter the management of lung transplant candidates. More selective screening strategies may be warranted.
authors.affiliation: Heart-Lung and Lung Transplant Program, Division of Pulmonary and Critical Care Medicine, Stanford University Medical Center, 300 Pasteur Drive, Room H3143, Stanford, CA 94305-5236, USA
authors.forename: L G
authors.initials: LG
authors.lastname: Singer
authors.forename: A B
authors.initials: AB
authors.lastname: Weinacker
authors.forename: L
authors.initials: L
authors.lastname: Levin
authors.forename: R L
authors.initials: RL
authors.lastname: Doyle
authors.forename: J
authors.initials: J
authors.lastname: Theodore
mesh_terms: D000236:Adenoma / Q000209:etiology; D018256:Adenomatous Polyps / Q000473:pathology; D015331:Cohort Studies; D003108:Colonic Diseases / Q000473:pathology*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012002:Rectal Diseases / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors