title: The 5-year outcome of patients having incomplete colonoscopy.
abstract: OBJECTIVE
  Incomplete colonoscopy indicated for the detection of neoplasia occurs in 2-23% of patients, but there is little information on the long-term outcome of such patients.
  
  
  METHODS
  All patients who underwent colonoscopy over 5 years at the Royal Liverpool University Hospital with a follow-up of up to 5 years were identified.
  
  
  RESULTS
  The risk of colorectal cancer (CRC) was 2.9% (312/10 580) for all patients undergoing colonoscopy. For a failed colonoscopy, the risk was five-fold higher [14.3% (99/693)]. The mean age of the patients was 61 years and 58% were female. Following incomplete colonoscopy the risk of finding additional CRC, advanced colonic neoplasia and extracolonic neoplasia on subsequent investigation was 6.2%, 3.2% and 1.9%. The diagnostic yield on subsequent investigation for CRC or colonic polyps was 7% for repeat colonoscopy, 13.4% for computed tomography colonography, 10.3% for standard computed tomography and 1.8% for barium enema. In the 363 patients who were not offered a subsequent investigation, there was no further instance of CRC or CRC-related mortality over a 36-month period.
  
  
  CONCLUSIONS
  Although the risk of CRC is higher in patients who have had a failed colonoscopy, a protocol approach of subsequent investigation should not replace clinical assessment on whether another test is necessary in the light of the good outcome of patients who were not subsequently investigated.
authors.affiliation: Department of Gastroenterology and Hepatology, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: E J
authors.initials: EJ
authors.lastname: Britton
authors.forename: S
authors.initials: S
authors.lastname: Sidhu
authors.forename: J
authors.initials: J
authors.lastname: Geraghty
authors.forename: E
authors.initials: E
authors.lastname: Psarelli
authors.forename: S
authors.initials: S
authors.lastname: Sarkar
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000453:epidemiology; D000368:Aged; D001466:Barium Sulfate; D002277:Carcinoma / Q000175:diagnosis* / Q000453:epidemiology; D015331:Cohort Studies; D003108:Colonic Diseases / Q000175:diagnosis / Q000453:epidemiology; D003111:Colonic Polyps / Q000175:diagnosis* / Q000453:epidemiology; D023881:Colonography, Computed Tomographic; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000453:epidemiology; D003287:Contrast Media; D043963:Diverticulosis, Colonic / Q000175:diagnosis / Q000453:epidemiology; D004733:Enema; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate
keywords: Endoscopy; failed colonoscopy; gastroenterology; outcomes; quality; risk of colorectal cancer