Procedural success and complications of large-scale screening colonoscopy

Douglas B. Nelson, Kenneth R. McQuaid, John H. Bond, David Lieberman, David G. Weiss, Tiina K. Johnston, William V. Harford, Dennis J. Ahnen, Dawn Provenzale, Stephen J. Sontag, Thomas G. Schnell, Donald R. Campbell, Theodore E. Durbin, John G. Lee, George Triadafilopoulos, Francisco C. Ramirez, Judith F. Collins, M. Brian Fennerty, Harinder Garewal, Richard E. Sampliner & 4 others Thomas G. Morales, Ronnie Fass, Robert E. Smith, Yogesh Maheshwari

Research output: Contribution to journalArticle

350 Citations (Scopus)

Abstract

Background: Indirect evidence and modeling analyses suggest that colonoscopy may be the most cost-effective way to screen the average-risk population for colorectal neoplasia. However, the success and safety of primary colonoscopic screening has not been prospectively evaluated in a multicenter trial. Methods: Asymptomatic subjects age 50 to 75 years who had not undergone examination of the colon within 10 years were recruited from the general medicine clinics of 13 Department of Veterans Affairs Medical Centers. Eligible patients underwent colonoscopy by study coinvestigators, at which time all polyps were measured, photographed, and removed. Patients were contacted at 24 hours and 1 week to track procedure-related complications. Results: Primary screening colonoscopy was performed in a cohort of 3196 asymptomatic subjects. A "good" preparation was reported in 81% of patients, and colonoscopy to the cecum was successful in 97.2% of cases. Mean insertion time to the cecum and total procedure times were 10.5 (8.7) and 30.6 (19.1) minutes, respectively. No preprocedural patient characteristics were identified that were predictive of an incomplete procedure. At least one polyp was resected in 1672 patients. There was no perforation and no death attributed to colonoscopy. Major morbidity considered to be definitely related to colonoscopy occurred in 9 of 3196 procedures (0.3%): lower GI bleeding requiring intervention (6), myocardial infarction and/or cerebrovascular accident (2), and thrombophlebitis (1). In subjects undergoing only diagnostic procedures, the major complication rate was 0.1%. Conclusions: Screening colonoscopy can be performed in multiple centers with a high degree of success and safety in large numbers of asymptomatic, average-risk men.

Original languageEnglish (US)
Pages (from-to)307-314
Number of pages8
JournalGastrointestinal Endoscopy
Volume55
Issue number3
DOIs
StatePublished - Mar 2002
Externally publishedYes

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Colonoscopy
Cecum
Polyps
Safety
Thrombophlebitis
Veterans
Multicenter Studies
Colon
Stroke
Myocardial Infarction
Medicine
Hemorrhage
Morbidity
Costs and Cost Analysis
Population
Neoplasms

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Nelson, D. B., McQuaid, K. R., Bond, J. H., Lieberman, D., Weiss, D. G., Johnston, T. K., ... Maheshwari, Y. (2002). Procedural success and complications of large-scale screening colonoscopy. Gastrointestinal Endoscopy, 55(3), 307-314. https://doi.org/10.1067/mge.2002.121883

Procedural success and complications of large-scale screening colonoscopy. / Nelson, Douglas B.; McQuaid, Kenneth R.; Bond, John H.; Lieberman, David; Weiss, David G.; Johnston, Tiina K.; Harford, William V.; Ahnen, Dennis J.; Provenzale, Dawn; Sontag, Stephen J.; Schnell, Thomas G.; Campbell, Donald R.; Durbin, Theodore E.; Lee, John G.; Triadafilopoulos, George; Ramirez, Francisco C.; Collins, Judith F.; Fennerty, M. Brian; Garewal, Harinder; Sampliner, Richard E.; Morales, Thomas G.; Fass, Ronnie; Smith, Robert E.; Maheshwari, Yogesh.

In: Gastrointestinal Endoscopy, Vol. 55, No. 3, 03.2002, p. 307-314.

Research output: Contribution to journalArticle

Nelson, DB, McQuaid, KR, Bond, JH, Lieberman, D, Weiss, DG, Johnston, TK, Harford, WV, Ahnen, DJ, Provenzale, D, Sontag, SJ, Schnell, TG, Campbell, DR, Durbin, TE, Lee, JG, Triadafilopoulos, G, Ramirez, FC, Collins, JF, Fennerty, MB, Garewal, H, Sampliner, RE, Morales, TG, Fass, R, Smith, RE & Maheshwari, Y 2002, 'Procedural success and complications of large-scale screening colonoscopy', Gastrointestinal Endoscopy, vol. 55, no. 3, pp. 307-314. https://doi.org/10.1067/mge.2002.121883
Nelson, Douglas B. ; McQuaid, Kenneth R. ; Bond, John H. ; Lieberman, David ; Weiss, David G. ; Johnston, Tiina K. ; Harford, William V. ; Ahnen, Dennis J. ; Provenzale, Dawn ; Sontag, Stephen J. ; Schnell, Thomas G. ; Campbell, Donald R. ; Durbin, Theodore E. ; Lee, John G. ; Triadafilopoulos, George ; Ramirez, Francisco C. ; Collins, Judith F. ; Fennerty, M. Brian ; Garewal, Harinder ; Sampliner, Richard E. ; Morales, Thomas G. ; Fass, Ronnie ; Smith, Robert E. ; Maheshwari, Yogesh. / Procedural success and complications of large-scale screening colonoscopy. In: Gastrointestinal Endoscopy. 2002 ; Vol. 55, No. 3. pp. 307-314.
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T1 - Procedural success and complications of large-scale screening colonoscopy

AU - Nelson, Douglas B.

AU - McQuaid, Kenneth R.

AU - Bond, John H.

AU - Lieberman, David

AU - Weiss, David G.

AU - Johnston, Tiina K.

AU - Harford, William V.

AU - Ahnen, Dennis J.

AU - Provenzale, Dawn

AU - Sontag, Stephen J.

AU - Schnell, Thomas G.

AU - Campbell, Donald R.

AU - Durbin, Theodore E.

AU - Lee, John G.

AU - Triadafilopoulos, George

AU - Ramirez, Francisco C.

AU - Collins, Judith F.

AU - Fennerty, M. Brian

AU - Garewal, Harinder

AU - Sampliner, Richard E.

AU - Morales, Thomas G.

AU - Fass, Ronnie

AU - Smith, Robert E.

AU - Maheshwari, Yogesh

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N2 - Background: Indirect evidence and modeling analyses suggest that colonoscopy may be the most cost-effective way to screen the average-risk population for colorectal neoplasia. However, the success and safety of primary colonoscopic screening has not been prospectively evaluated in a multicenter trial. Methods: Asymptomatic subjects age 50 to 75 years who had not undergone examination of the colon within 10 years were recruited from the general medicine clinics of 13 Department of Veterans Affairs Medical Centers. Eligible patients underwent colonoscopy by study coinvestigators, at which time all polyps were measured, photographed, and removed. Patients were contacted at 24 hours and 1 week to track procedure-related complications. Results: Primary screening colonoscopy was performed in a cohort of 3196 asymptomatic subjects. A "good" preparation was reported in 81% of patients, and colonoscopy to the cecum was successful in 97.2% of cases. Mean insertion time to the cecum and total procedure times were 10.5 (8.7) and 30.6 (19.1) minutes, respectively. No preprocedural patient characteristics were identified that were predictive of an incomplete procedure. At least one polyp was resected in 1672 patients. There was no perforation and no death attributed to colonoscopy. Major morbidity considered to be definitely related to colonoscopy occurred in 9 of 3196 procedures (0.3%): lower GI bleeding requiring intervention (6), myocardial infarction and/or cerebrovascular accident (2), and thrombophlebitis (1). In subjects undergoing only diagnostic procedures, the major complication rate was 0.1%. Conclusions: Screening colonoscopy can be performed in multiple centers with a high degree of success and safety in large numbers of asymptomatic, average-risk men.

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