Colonic neoplasia in patients with nonspecific GI symptoms

Background: The purpose of this study was to determine the prevalence rate of colonic polyps or masses 1 cm or greater in diameter in patients with no nspecific abdominal symptoms, from diverse practice settings, using a natio nal endoscopic database. Methods: Consecutive patients undergoing colonoscopy were included based on procedure indication, Endoscopic data were generated with a computer datab ase at each practice site, transmitted to a central data bank and merged wi th data from multiple sites for analysis. Group 1 patients had nonspecific abdominal symptoms, which were defined as pain, constipation and diarrhea. Group 2 patients had a positive fecal occult blood test, Group 3 patients w ere asymptomatic, undergoing screening colonoscopy, Serious colon pathology was defined as a polyp or mass greater than 9 mm in size. Results: Data were collected from 31 practice sites in 21 states during a p eriod of 18 months, Of the 20,745 colonoscopy examinations, 9.2% were perfo rmed to evaluate patients with nonspecific abdominal symptoms, excluding ot her indications. Among patients with nonspecific symptoms 7.27% had polyp(s ) 1 cm or greater in diameter compared with 17.05% of patients with positiv e fecal occult blood test (odds ratio 2.12: Cl [1.73, 2.60]; p < 0.001). Pa tients with nonspecific symptoms had similar rates of large polyps as asymp tomatic patients (7.27% vs. 6.45%, p = 0.32). Multivariate analysis identif ied several independent variables including increasing age, male gender and practice site at a Veterans Affairs Medical Center. Conclusions: In diverse, practice-based settings, patients with nonspecific abdominal symptoms who are referred for colonoscopy do not have a higher r isk of serious colonic pathology than asymptomatic patients.