Researchers from Canada and the USA determined the yield of colonoscopy in patients with nonacute rectal bleeding.
A total of 1766 patients (711 women, median age 57 years) were included in the retrospective study.
Multiple logistic regression analysis was performed to identify variables independently associated with the presence of isolated significant proximal disease.
The team found that young patients had a higher percentage of normal examinations than did older patients.
The incidence of diverticular disease, small polyps, large polyps, and cancer rose with increasing age.
No patient aged less than 40 years had an isolated proximal cancer. However, 7% had other significant isolated proximal disease.
|7% of young patients had other significant isolated proximal disease.|
|American Journal of Gastroenterology|
There was found to be no overall association between age and significant proximal disease, in the absence of significant distal disease.
The only variable associated with isolated proximal disease was anemia (odds ratio = 1.81).
Dr H. E. Mulcahy, of the Digestive Disease Center, Medical University of South Carolina, Charleston, South Carolina, said on behalf of the group, "The yield of colonoscopy (beyond the range of sigmoidoscopy) for neoplasia is low in patients aged less than 40 years.
"However, other significant disease may be missed if age is the only criterion determining colonoscopy use," it was concluded.