Diagnostic yield of screening colonoscopies in lung transplant candidates

Background. Colonoscopy has been used to screen lung transplant candidates for colorectal diseases that would preclude transplantation. The diagnostic yield of this procedure is unknown. Methods. This is a retrospective cohort study of patients 50 years of age a nd over who underwent lung transplant evaluations from 1996 to 1999. We ass essed the prevalence and location of colonoscopic abnormalities, the predic tive value of risk factors for colonic neoplasms, and the impact of colonos copic findings on management. Results. Thirty-one patients were evaluated. Twenty-four patients had at le ast one abnormal endoscopic finding. Six patients (19%) had adenomatous pol yps; no carcinomas were detected. The 13 patients with risk factors were mo re likely to have adenomas (relative risk = 2.8, P = 0.2). The negative pre dictive value of risk factors for adenomas was 89%. One patient's managemen t was altered and none were denied transplant listing because of the colono scopic findings. Conclusions. Screening colonoscopy did not substantively alter the manageme nt of lung transplant candidates. More selective screening strategies may b e warranted.