Système gastro-intestinal et digestif

Abstrait

Increasing Use of Colonoscopy Over a Decade has Detected an Increased Prevalence of Colorectal Tumors on the Elderly

Takashi Hashimoto, Taro Osada, Shingo Pablo Goto, Naoto Sakamoto, Takashi Murakami, Hideaki Ritsuno, Dai Ishikawa, Kenshi Matsumoto, Tomoyoshi Shibuya, Sumio Watanabe

Objective: The advancement of endoscopic technology has brought an increase in colonoscopic examinations. We analyzed the change in the prevalence of colorectal tumors in elderly patients (80 years or older) over a decade. Method: A total of 10,516 patients who were admitted to our hospital for colonoscopic examinations from 2009 to 2011 (recent period) were analyzed and compared with 8,767 historical cases from 1999 to 2001 (prior period). The proportion of patients who were elderly, reason for colonoscopy, completion rate and detection of tumors were analyzed in each period. Results: The rate of elderly patients significantly increased from 2.86% in the prior period to 5.40% in the recent period (p<0.001). As to the reasons for colonoscopy, a double-contrast barium enema X-ray study suggestive of colorectal carcinoma significantly decreased from 6.4% to 1.1% (p<0.001) and screening studies in the elderly significantly increased from 12.7% to 25.2% (p<0.001). The completion rate in the elderly improved (prior period 87.2%, recent period 93.59%, p=0.005). The detection of colorectal tumors was significantly higher in elderly (47.5%) than in non-elderly patients (37.3%, p<0.001) and the proportion of elderly with colorectal adenoma significantly increased from 2.95% in the prior period to 6.54% in the recent period (p<0.001). However, the detection rate of tumors in the elderly significantly decreased over a decade (prior period 54.2%, recent period 47.5%, p<0.001). Conclusions: The proportion of the elderly population is increasing with increasing frequency of colonoscopic examinations performed. Extra care might be required when performing endoscopic examination in the elderly