Colonoscopy indications and findings in older adults

Abstract

Aims: The share of older population is increasing globally. Colonoscopy is a frequently used diagnostic/therapeutic procedure, no study to our knowledge comprehensively examines the indications and findings of colonoscopy in geriatric population. We aimed to reveal these in older adults. Methods: Colonoscopy procedures performed in older adults (≥65 years), which covered a 5-year period (2017-2022), were analyzed retrospectively. Indications and findings of colonoscopies were assessed. The relationship between the indications and the associated findings was also evaluated on an indication basis. Results: In the study, 2370 colonoscopy procedures were examined. 27.8% were performed in very old (≥75 years) patients. Colonoscopy was completed in 84.3%. Colon cleansing was not optimal in approximately one-fourth. The frequency of completion of colonoscopies and optimal cleaning were similar in the very old. Iron deficiency anemia (IDA) or fecal occult blood test (FOBT) positivity and screening colonoscopy were the common indications. Regarding indications, IDA-FOBT positivity and bleeding were more frequent, screening colonoscopy, IBD and polyp control were less frequent in the very old group. Colonoscopy was reported as normal in 42.4% of the patients, while polyps (28.3%) and diverticula (17.5%) were the common findings. Among findings tumor, diverticula and solitary rectal ulcer were higher in the very old. IDA -FOBT positivity, bleeding, and colonoscopy performed due to findings of other imaging modalities were related to diagnosis of a tumor. Conclusion: In this study, we presented the indications and results of colonoscopy in a large number of older patients. The main indications for colonoscopy can be listed as IDA-FOBT positivity, screening colonoscopy and control of previous polyp-tumor. Near one of two colonoscopies were found to be normal, polyps and diverticula were the major pathologies in the rest. It should be emphasized that IDA -FOBT positivity, bleeding, and findings of other imaging modalities were related to tumor in colonoscopy.