Colonoscopic yield of colorectal neoplasia in daily clinical practice.
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.
Terhaar Sive Droste
Jochim S
JS
Department of Gastroenterology and Hepatology, VU University Medical Centre, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. js.terhaar@vumc.nl
Craanen
Mike E
ME
van der Hulst
Rene W M
RW
Bartelsman
Joep F
JF
Bezemer
Dick P
DP
Cappendijk
Kim R
KR
Meijer
Gerrit A
GA
Morsink
Linde M
LM
Snel
Pleun
P
Tuynman
Hans A R E
HA
van Wanrooy
Roy L J
RL
Wesdorp
Eric I C
EI
Mulder
Chris J J
CJ
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