Colonoscopy in the very old: why bother?
OBJECTIVE
To evaluate the use of colonoscopy in patients aged at least 85 years. Does the ideal of an ageism free service apply?


METHODS
A retrospective audit.


METHODS
Department of gastroenterology that carries out about 1000 colonoscopies annually in a district general hospital serving a population of about 320 000.


METHODS
All patients aged at least 85 years who underwent colonoscopy over five years to 2003.


METHODS
The indications for colonoscopy and its findings. The outcome of patients found to have colonic cancers.


RESULTS
Colonoscopy was completed in 219 cases (69%). The main reasons for failure were poor bowel preparation and severe diverticular disease. Normal findings occurred in 65 (30%) of the 219 cases that had had a complete examination. Colonoscopy identified a problem that explained the patient's symptoms in 116 (37%) cases. Polyps were found in 45 (14.2%) cases and malignancy in 28 (8.8%).


CONCLUSIONS
The absence of significant complications and comparatively high yield of colonic malignancies and polyps reinforces the value of colonoscopy as a diagnostic tool even after 85 years of age and despite the technical challenges of the procedure in this age group that limited completion. Increasing age alone should not preclude a patient from colonoscopy.
Yoong
K K Y
KK
Department of Gastroenterology, Kingston Hospital NHS Trust, Galsworthy Road, Kingston upon Thames KT2 7QB, UK. k_y_yoong@hotmail.com
Heymann
T
T
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000175:diagnosis*; D003110:Colonic Neoplasms / Q000175:diagnosis; D003113:Colonoscopy / Q000009:adverse effects / Q000706:statistics & numerical data*; D004739:England; D015276:Health Care Rationing; D006801:Humans; D008485:Medical Audit; D011287:Prejudice; D012189:Retrospective Studies