title: Colonoscopic yield of colorectal neoplasia in daily clinical practice.
abstract: OBJECTIVE
  To assess the prevalence and location of advanced neoplasia in patients undergoing colonoscopy, and to compare the yield per indication.
  
  
  METHODS
  In a multicenter colonoscopy survey (n = 18 hospitals) in the Amsterdam area (Northern Holland), data of all colonoscopies performed during a three month period in 2005 were analyzed. The location and the histological features of all colonic neoplasia were recorded. The prevalence and the distribution of advanced colorectal neoplasia and differences in yield between indication clusters were evaluated. Advanced neoplasm was defined as adenoma > 10 mm in size, with > 25% villous features or with high-grade dysplasia or cancer.
  
  
  RESULTS
  A total of 4623 eligible patients underwent a total colonoscopy. The prevalence of advanced neoplasia was 13%, with 281 (6%) adenocarcinomas and 342 (7%) advanced adenomas. Sixty-seven percent and 33% of advanced neoplasia were located in the distal and proximal colon, respectively. Of all patients with right-sided advanced neoplasia (n = 228), 51% had a normal distal colon, whereas 27% had a synchronous distal adenoma. Ten percent of all colonoscopies were performed in asymptomatic patients, 7% of whom had advanced neoplasia. In the respective procedure indication clusters, the prevalence of right-sided advanced neoplasia ranged from 11%-57%.
  
  
  CONCLUSIONS
  One out of every 7-8 colonoscopies yielded an advanced colorectal neoplasm. Colonoscopy is warranted for the evaluation of both symptomatic and asymptomatic patients.
authors.affiliation: Department of Gastroenterology and Hepatology, VU University Medical Centre, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. js.terhaar@vumc.nl
authors.forename: Jochim S
authors.initials: JS
authors.lastname: Terhaar Sive Droste
authors.forename: Mike E
authors.initials: ME
authors.lastname: Craanen
authors.forename: Rene W M
authors.initials: RW
authors.lastname: van der Hulst
authors.forename: Joep F
authors.initials: JF
authors.lastname: Bartelsman
authors.forename: Dick P
authors.initials: DP
authors.lastname: Bezemer
authors.forename: Kim R
authors.initials: KR
authors.lastname: Cappendijk
authors.forename: Gerrit A
authors.initials: GA
authors.lastname: Meijer
authors.forename: Linde M
authors.initials: LM
authors.lastname: Morsink
authors.forename: Pleun
authors.initials: P
authors.lastname: Snel
authors.forename: Hans A R E
authors.initials: HA
authors.lastname: Tuynman
authors.forename: Roy L J
authors.initials: RL
authors.lastname: van Wanrooy
authors.forename: Eric I C
authors.initials: EI
authors.lastname: Wesdorp
authors.forename: Chris J J
authors.initials: CJ
authors.lastname: Mulder
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D000740:Anemia / Q000209:etiology; D003106:Colon / Q000033:anatomy & histology / Q000473:pathology; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology*; D007839:Functional Laterality; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D015431:Weight Loss