title: Colonoscopy in the very elderly: a review of 157 cases.
abstract: BACKGROUND
  Colonoscopy is currently the best diagnostic modality for evaluating colonic diseases but studies of its use in the very elderly are limited.
  
  
  METHODS
  A single-institution review of all patients aged 85 years or older who underwent colonoscopy from June 2003 to June 2005 was performed. Parameters evaluated included indications for colonoscopy, findings, ability to perform a complete colonoscopy, and immediate and delayed (< or =21 days) complications.
  
  
  RESULTS
  A total of 157 patients aged 85 years or older (median = 87, range = 85-99) underwent colonoscopy during the two-year period. The cecal intubation rate was 90%. Number of cancers detected/indications for colonoscopy include gross or occult bleeding per rectum, 3/51 (5.9%); abnormal physical exam, 1/2 (50%); abnormal abdominal computed tomography, 3/5 (60%); anemia, 1/25 (4.0%); screening, 0/14; previous history of colonic malignancy, 0/10; previous history of polyps, 0/21; change in bowel habits, 0/5; family history of colonic malignancy, 0/6; abdominal pain, 0/4; diarrhea, 0/6; fecal impaction, 0/2; unknown, 0/6. Immediate complications included hemorrhage at a polypectomy site in one patient that was controlled endoscopically, one episode of bradycardia, and one incident of atrial fibrillation. There were no delayed complications resulting from colonoscopy.
  
  
  CONCLUSIONS
  Our data suggest that colonoscopy can be safely and successfully performed in the very elderly. In patients with symptoms or suggestive radiographic findings, cancer was detected in 4.0%-60% of cases. No cases of cancer were discovered in those patients who were asymptomatic.
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, NC, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Zerey
authors.forename: B Lauren
authors.initials: BL
authors.lastname: Paton
authors.forename: Philip D
authors.initials: PD
authors.lastname: Khan
authors.forename: Amy E
authors.initials: AE
authors.lastname: Lincourt
authors.forename: Kent W
authors.initials: KW
authors.lastname: Kercher
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Greene
authors.forename: B Todd
authors.initials: BT
authors.lastname: Heniford
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000175:diagnosis*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies