title: Outpatient colonoscopy complications in the CDC's Colorectal Cancer Screening Demonstration Program: a prospective analysis.
abstract: BACKGROUND
  To the authors's knowledge, there are few published prospective cohort studies of colonoscopy complications in patients at average risk for colorectal cancer who received colorectal cancer screening from a community-based program. In this article, the authors report the rate of colonoscopy complications in the Centers for Disease Control and Prevention (CDC)'s Colorectal Cancer Screening Demonstration Program (CRCSDP), which provided colorectal cancer screening to a medically underserved population aged 50 years to 64 years for screening, diagnostic follow-up after positive stool blood tests, and surveillance purposes.
  
  
  METHODS
  Clinical data were collected prospectively from 5 community-based colorectal cancer screening programs. Complications were identified by reviewing the standardized clinical data and medical complication reporting forms submitted by the programs to the CDC. Serious complications were defined as conditions or symptoms that resulted in hospital admission within 30 days after the procedure, including perforation, gastrointestinal bleeding requiring or not requiring blood transfusion, cardiopulmonary events, postpolypectomy syndrome, excessive abdominal pain, or death.
  
  
  RESULTS
  A total of 3215 individuals underwent 3355 colonoscopies. Of these, 89% of the colonoscopies were conducted for screening, 9% were conducted for diagnostic follow-up, and 2% were conducted for surveillance purposes. The mean age of the individuals was 55.9 years. Eight individuals experienced serious complications, for an incidence of 2.38 per 1000 colonoscopies. Three patients experienced bowel perforations that required surgery, 1 patient was hospitalized for postpolypectomy bleeding, 3 patients experienced cardiopulmonary events, and 1 patient visited the emergency room for excessive abdominal pain and underwent surgery for an identified colorectal mass. No deaths were reported.
  
  
  CONCLUSIONS
  In the CDC's CRCSDP, in which a total of 3215 individuals underwent 3355 colonoscopies, the overall incidence of serious complications from colonoscopy was found to be low.
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3717, USA. Gcastro@cdc.gov
authors.forename: Georgina
authors.initials: G
authors.lastname: Castro
authors.forename: M Fuad
authors.initials: MF
authors.lastname: Azrak
authors.forename: Laura C
authors.initials: LC
authors.lastname: Seeff
authors.forename: Janet
authors.initials: J
authors.lastname: Royalty
mesh_terms: D000553:Ambulatory Care / Q000379:methods; D002487:Centers for Disease Control and Prevention, U.S.; D015331:Cohort Studies; D003113:Colonoscopy / Q000009:adverse effects* / Q000379:methods; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D055088:Early Detection of Cancer / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014481:United States
keywords: colonoscopy; colorectal cancer; complications; perforation; screening