Colonoscopy in octogenarians: a review of 428 cases

Studies on the use of colonoscopy in the octogenarian are few. Therefore th is study evaluated the re suits and cost-effectiveness of colonoscopy in oc togenarians. A total of 403 patients 80 years of age or older who underwent colonoscopy from May 1994 to May 1996 were reviewed (median 84, range 80-9 5). Parameters evaluated were indications for colonoscopy, significant endo scopic findings (biopsy-confirmed adenocarcinoma and adenomatous polyps gre ater than or equal to 1 cm), complications, colonoscopy completion rate, an d mean charge per procedure Postpolypectomy bleeding occured in one point T he cecal intubation rate was 94%. The calculated cost per procedure was U.S . $2,342. Indications for colonoscopy/number of cancers detected include: c hange in bowel habits, 78/2; blood/hemoccult positive, 69/8; abdominal pain , 12/0; constipation, 9/0; diarrhea, 8/0; surveillance for history of polyp s, 159/3; surveillance for history of cancer, 51/1; cancer or polyp on sigm oidoscopy, 42/4. The cancer detection rate in patients with bleeding was 11 .5%, compared with 1.9% for all other symptoms. Colonoscopy can be safely p erformed in the octogenarian population. Our data suggest that more stringe nt selection criteria for colonoscopy in the octogenarian could result in s ignificant cost savings.