[Appropiateness of colonoscopy in a gastrointestinal unit in 2001: a prospective study using criteria established by a European panel of experts].
Criteria for appropriateness of colonoscopy have been elaborated by an European Panel (EPAGE).


OBJECTIVE
1) To assess the feasibility of EPAGE criteria in clinical practice, 2) to assess colonoscopy appropriateness using EPAGE criteria, 3) to compare colonoscopy appropriateness and findings.


METHODS
Four hundred and six consecutive examinations were included. The referral indication was judged using a scoring system on the basis of the EPAGE criteria.


RESULTS
Appropriateness could be assessed in 94% of the colonoscopies. Fifty-four percent were appropriate, 40% equivocal, and 6% inappropriate. Rate of abnormal colonoscopy was not different between the 3 groups, however endoscopic findings were more severe when the indication was appropriate. In the appropriate group, adenomatous polyps were more frequent (24%) than in the two other groups (13% and 12%; P<0.05) and tended to be larger in size. In the inappropriate group, patients were significantly younger, and no cancer was found. There were 5 colonic cancers in the inappropriate group and 12 in the appropriate group.


CONCLUSIONS
Colonoscopy is generally not overused according to EPAGE guidelines. However, on an individual basis it could be rather difficult to determine colonoscopy appropriateness using a scoring system. Indeed, a third of the indications was judged equivocal and the endoscopic findings were no different whether indication was appropriate or equivocal.
Kmieciak Le Corguillé
Monika
M
Service d'Hépato-Gastroentérologie, Hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75679 Paris Cedex 14. kmieciak@bigfoot.com
Gaudric
Marianne
M
Sogni
Philippe
P
Roche
Hervé
H
Brézault
Catherine
C
Dieumegard
Barbara
B
Couturier
Daniel
D
Chaussade
Stanislas
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000592:standards* / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006757:Hospital Units; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies