CLINICAL AUDIT

Colonoscopy in the very old: why bother?

K K Y Yoong¹, T Heymann²

¹ Department of Gastroenterology, Kingston Hospital NHS Trust, Kingston upon Thames, UK
² Tanaka Business School, Imperial College London, London, UK

Correspondence to:
Correspondence to:
Dr K K Y Yoong
Department of Gastroenterology, Kingston Hospital NHS Trust, Galsworthy Road, Kingston upon Thames KT2 7QB, UK; k_y_yoong{at}hotmail.com

Objectives: To evaluate the use of colonoscopy in patients aged at least 85 years. Does the ideal of an ageism free service apply?

Design: A retrospective audit.

Setting: Department of gastroenterology that carries out about 1000 colonoscopies annually in a district general hospital serving a population of about 320 000.

Subjects: All patients aged at least 85 years who underwent colonoscopy over five years to 2003.

Main outcome measures: The indications for colonoscopy and its findings. The outcome of patients found to have colonic cancers.

Results: Colonoscopy was completed in 219 cases (69%). The main reasons for failure were poor bowel preparation and severe diverticular disease. Normal findings occurred in 65 (30%) of the 219 cases that had had a complete examination. Colonoscopy identified a problem that explained the patient’s symptoms in 116 (37%) cases. Polyps were found in 45 (14.2%) cases and malignancy in 28 (8.8%).

Conclusions: The absence of significant complications and comparatively high yield of colonic malignancies and polyps reinforces the value of colonoscopy as a diagnostic tool even after 85 years of age and despite the technical challenges of the procedure in this age group that limited completion. Increasing age alone should not preclude a patient from colonoscopy.

Keywords: colonoscopy; elderly patients

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• Quarini, C., Gosney, M. (2009). Review of the evidence for a colorectal cancer screening programme in elderly people. Age Ageing 38: 503-508 [Abstract] [Full Text]  
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