March 8, 2009

Low Risk of Perforation During Colonoscopy Screening for Colorectal Cancer


Low Risk of Perforation During Colonoscopy Screening for Colorectal Cancer

Perforation (a tear through the colon wall caused by a colonoscopy procedure) occurs in less than one in 1,000 patients undergoing a colonoscopy. These results were recently published in the Archives of Surgery.

A colonoscopy is a procedure that involves the insertion of a lighted tube through the large intestine to allow a physician to examine the entire colon for abnormal areas. A colonoscopy is the preferred method for detecting early colon cancer and is recommended every 5-10 years beginning at age 40-50 years for average-risk individuals. Despite these recommendations, however, the rate of colonoscopy screening remains 10% or lower in the United States. Researchers are analyzing factors associated with this low compliance rate, with suspected variables being the invasiveness of the procedure, the cost, and the perceived risk of the procedure, especially that of perforation.

Researchers from the Mayo Clinic recently evaluated data in an attempt to understand the rate of perforations associated with colonoscopies. The data included 258,248 colonoscopies.

  • The rate of perforation was only 0.7%.
  • Blunt injuries, poor bowel preparation, corticosteroid use, and younger age increased the incidence of adverse effects associated with colonoscopy.

These data indicate that the risk of perforations during a colonoscopy remains very low, but that the risk factors associated with perforations are important to understand.

Patients with any of the factors associated with an increased risk of perforation may wish to speak with their physician regarding their individual risks and benefits of undergoing a colonoscopy.

Reference: Iqbal CW, Cullinane DC, Schiller HJ, et al. Surgical management and outcomes of 165 colonoscopic perforations from a single institution. Archives of Surgery. 143:701-707. 2008

Related News: Physicians with More Training Perform More Effective Colonoscopies (05/07/2008)

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