title: Colonoscopy in the octogenarian population: diagnostic and survival outcomes from a large series of patients.
abstract: OBJECTIVE
  Our aim was to audit the diagnostic and survival outcomes of colonoscopy in octogenarians and to determine if it confers any survival benefit.
  
  
  METHODS
  A review of a prospectively maintained database over a two year period between October 2005 and September 2007 was undertaken. Data on numerous outcome variables and survival were collected and analysed. Categorical variables were compared using the Chi-square test. Kaplan-Meier survival curves were constructed and log rank test were used to compare survival curves.
  
  
  RESULTS
  There were 1905 patients, of which 289 (15%) were over the age of 80 years. Caecal intubation was significantly lower in octogenarians when compared with young patients (239/289, (82%) vs. 1411/1616 (88%), p = 0.025). The most common reason for failure to intubate the caecum was presence of stenosing pathology in distal bowel (octogenarians 46% (23 out of 50 failed intubations) vs. young 23% (49 out of 205 failed intubations), p = 0.002). A greater proportion of octogenarians had poor bowel preparation when compared with the young (20% vs. 13%, p = 0.001). Significantly more pathology was detected in octogenarians (72% vs. 59%, p = 0.001). Forty-four (15.2%) octogenarians were found to have malignancy. Of these, only 23 (52%) underwent subsequent surgery. Median survival of octogenarians who had surgery was not statistically better (31 (IQR 12-38) months vs. 16 (IQR 5-31) months, p = 0.10) than those who did not.
  
  
  CONCLUSIONS
  Colonoscopy is safe in octogenarians and provides a high yield. Our results suggest that it does not appear to result in any survival benefit. However, to establish this, further research with larger cohorts and longer follow-up periods would be required.
authors.affiliation: The Combined Gastroenterology Research Unit, Scarborough Hospital, Woodlands Drive, Scarborough, Yorkshire YO12 6QL, United Kingdom. Shakeeb.a.khan@gmail.com
authors.forename: Shakeeb
authors.initials: S
authors.lastname: Khan
authors.forename: Jamil
authors.initials: J
authors.lastname: Ahmed
authors.forename: Michael
authors.initials: M
authors.lastname: Lim
authors.forename: Anwar
authors.initials: A
authors.lastname: Owais
authors.forename: Clare
authors.initials: C
authors.lastname: McNaught
authors.forename: Karl
authors.initials: K
authors.lastname: Mainprize
authors.forename: Sathish
authors.initials: S
authors.lastname: Babu
authors.forename: Ian
authors.initials: I
authors.lastname: Renwick
authors.forename: John
authors.initials: J
authors.lastname: Macfie
authors.forename: Charles
authors.initials: C
authors.lastname: Mitchell
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000175:diagnosis* / Q000453:epidemiology; D003113:Colonoscopy / Q000706:statistics & numerical data*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D006113:United Kingdom / Q000453:epidemiology