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Colonoscopy Risks Increase With Age and Illness
Date:6/15/2009

did not have colonoscopies.

The researchers looked for claims made to Medicare for bleeding, perforation of the colon and heart problems resulting from the procedure.

Warren's group found that those undergoing colonoscopy had a greater risk of adverse events than those who did not have the procedure. The rates of these problems increased with age, the researchers noted.

Moreover, patients who had a polyp removed during the procedure had a higher risk for adverse events than those without polypectomy.

Patients with a history of stroke, chronic obstructive pulmonary disease, atrial fibrillation or congestive heart failure -- or multiple chronic conditions -- had a higher risk for bleeding and colon perforation, the researchers found.

Dr. Thomas Imperiale, a professor of medicine at Indiana University Medical Center in Indianapolis, said these findings will help clinicians better tailor the risks of colonoscopy to their patients.

"In addition to describing to patients an average, overall risk, we can be more precise in our explanation of perforation risk, based on the patient's age, their medical conditions, the indication for the colonoscopy and whether a polyp is removed," he said.

"Providers need to be thoughtful about assessing the benefits and risks of colonoscopy for every patient and for any indication, but especially for screening, where there is arguably less potential for benefit than for a diagnostic or therapeutic colonoscopy," Imperiale said.

Another expert says the study demonstrates that colonoscopy, even among the elderly, is generally safe and should not be discounted on age alone.

"One should be cautious about interpreting this data without putting it into the context of the potential benefits to the patients," said Dr. George Chang, an assistant professor of surgical oncology at the University of Texas M.D. Anderson Cancer Center.

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