[Appropriateness of colonoscopy indications according to the new EPAGE II criteria].
BACKGROUND
The appropriateness criteria for colonoscopy developed by a European expert panel (EPAGE), published in 1999, were revised this year (EPAGE II), but have not yet been evaluated.


OBJECTIVE
(1) To analyze colonoscopies performed at our hospital, and (2) to evaluate the appropriateness of the new EPAGE II criteria.


METHODS
We retrospectively analyzed 700 colonoscopies (48% males, mean age 58 years). Forty-five colonoscopies (6.4%) were excluded for insufficient bowel preparation or elective indication. EPAGE II criteria classified colonoscopies as "appropriate", "inappropriate" and "uncertain".


RESULTS
Ninety-four percent (n=655) of colonoscopies were evaluated. The most frequent indication for colonoscopy (19%) was screening of colorectal cancer (CRC). Seventy percent of colonoscopies were "appropriate", and 18% were "inappropriate", with significant differences according to where the request was made. The most inappropriate indication was postpolypectomy follow-up, due to shorter follow-up intervals. An endoscopic diagnosis was made in 315 patients (48%), with a finding of significant lesions in 25% (n=167; CCR, adenomas, inflammatory bowel disease, angiodysplasia and benign stricture). The indications most frequently associated with relevant findings were screening of CRC (17.3%) and postpolypectomy follow-up (16.7%) but this association was non-significant. Only iron-deficiency anemia was significantly associated with CRC (p<0.0001).


CONCLUSIONS
Eighteen percent of requests for colonoscopy were inappropriate and 12% provided incomplete information. The indication most strongly associated with a diagnosis of CRC was iron-deficiency anemia. The EPAGE II criteria showed a significant correlation with an endoscopic diagnosis of CRC.
Carrión
Silvia
S
Unidad de Endoscopia Digestiva, Servicio de Aparato Digestivo, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
Marín
Ingrid
I
Lorenzo-Zúñiga
Vicente
V
Moreno De Vega
Vicente
V
Boix
Jaume
J
D003108:Colonic Diseases / Q000175:diagnosis*; D003113:Colonoscopy / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies