medwireNews: Researchers have provided evidence that colonoscopy is a well tolerated and worthwhile procedure for colorectal cancer patients, with regard to late-onset and non-gastrointestinal (non-GI) adverse events (AEs).
In a retrospective cohort study including a total of 66,172 individuals, the occurrence of delayed and non-GI events after colonoscopy in routine practice was rare, they say.
Despite growing concerns about AEs associated with colonoscopy, there are still few large-scale studies that have assessed the incidence of serious AEs over the recommended period of 30 days after colonoscopy, explain Christian Stock (German Cancer Research Center, Heidelberg) and colleagues.
"This study is the first large-scale investigation on risks of colonoscopy performed in the German healthcare system that used a 30-day follow up period."
In the case-control study of 33,086 individuals who underwent colonoscopy either for screening purposes (n=8658) or due to medical implications (n=24,428), the incidence of AEs ranged from 0.2 (myocardial infarction) to 0.8 (perforation) per 1000 cases of screening colonoscopies and from 0.4 (myocardial infarction) to 1.1 (bleeding) per 1000 cases of nonscreening colonoscopies.
Generally, very similar incidences of AEs were observed for screening and nonscreening colonoscopies and the incidence of hospitalizations due to perforation, bleeding, and non-GI AEs was uncommon or rare in both colonoscopy groups, reports the team.
As reported in Gastrointestinal Endoscopy, the incidence of AEs was similar between those exposed to colonoscopy and controls except for in the case of perforation and bleeding outcomes, which were significantly increased among colonoscopy patients.
However, the researchers point out that most cases of perforation and bleeding only occurred when colonoscopic polypectomy was performed.
"Colonoscopic polypectomy and biopsy are known risk factors for perforation and bleeding," they write. "But these are the cases where patients profit most from colonoscopy, which may have saved their lives."
In addition, none of the hospitalizations caused by perforation and bleeding occurred more than 4 to 14 days after colonoscopy, note the researchers, who suggest that "a 14-day period for reporting would capture all perforations and the majority of bleedings requiring hospital admission."
The team concludes: "The results of this study, along with the existing evidence of the potential risks associated with a colonoscopy, may be particularly useful for gastroenterologists to inform patients about potential risks of a colonoscopy in routine practice."
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