Article Figures & Tables
Figures
- Figure 1:
Flow diagram showing activities related to colonoscopy and subsequent follow-up to identify serious adverse events.
- Figure 2:
Flow diagram of study cohort. *Transcription errors: an unplanned event was recorded, but none occurred.
Tables
Characteristic Data value Age, yr, median (10th–90th percentile) 62 (52–71) Sex, male, no. (%) of participants 51 466 (56) No. of colonoscopies performed 96 192 No. (%) with removal of polyps 62 647 (65.1) No. (%) with removal of precancerous polyps 51 150 (53.2) No. (%) with removal of large precancerous polyps* 15 143 (15.7) ↵* Precancerous polyp ≥ 10 mm in diameter.
- Table 2:
Serious adverse events probably or possibly related to colonoscopy and their outcomes
Serious adverse event No. of patients with event* Outcome; no. of patients Repeat colonoscopy Surgery Death Perforation† 48 1 41 1 Bleeding 203 102 4 0 Post-polypectomy syndrome‡ 15 0 0 0 Bowel preparation§ 12 2 1 0 Splenic injury 4 0 1 0 Cardiovascular¶ 16 0 4 0 Respiratory** 3 1 0 0 Other†† 31 2 9 1 Total 332 108 60 2 ↵* In each row, the sum of values for outcomes is less than the number of patients with the event because some patients had no or multiple interventions related to the adverse event.
↵† Includes 1 patient with post-polypectomy bleeding who sustained a perforation as a complication of endoscopic therapy during repeat colonoscopy.
↵‡ Abdominal pain, fever, peritoneal signs without perforation following colonoscopy and polypectomy.
↵§ Serious adverse events that occurred during preparation, before colonoscopy: vomiting (n = 6), hematemesis (n = 2), arrythmia (n = 1), fall (n = 1), seizure (n = 1), worsening renal function requiring dialysis (n = 1).
↵¶ Cardiac event (acute coronary syndrome [n = 7] or arrythmia [n = 4]), cerebrovascular event (n = 2), thromboembolic event (n = 2), abdominal aortic dissection (n = 1).
↵** Pneumonia (n = 1), hypoxia (n = 2).
↵†† Includes infection (n = 6), small-bowel obstruction (n = 3), fall (n = 2), diverticulitis (n = 2), acute kidney injury (n = 2), appendicitis (n = 1), large-bowel obstruction (n = 1), hemorrhoids (n = 1), seizure (n = 1), hospital admission for various other symptoms and no clear diagnosis (n = 11). In addition, 1 patient died at home.
- Table 3:
Risks associated with colonoscopy in FOBT-based screening programs for colorectal cancer
Study location No. of patients Ascertainment FOBT Polyp removal, % Follow-up Event; rate, per 10 000 All Perforation Bleeding Death British Columbia (current study) 96 192 Phone call 14 d after colonoscopy FIT 65 14 d 44 6 26 0.3 Basque, Spain (14) 39 254 Hospital admission data FIT NR 30 d 100 27 62 NR Denmark (15) 14 671 Chart review of cases identified through hospital admission data FIT 55 14 d for bleeding
30 d for other SAEs
90 d for death61 10 41 0.7 Slovenia (16) 13 919 Physician and/or patient had option of mailing standardized form to program FIT NR NR 8 8 3 NR England (17) 130 831 Mailed questionnaire 30 d after colonoscopy Guaiac
FOBT53 30 d 142 6 65 0 Alsace, France (18) 10 277 Phone call 1 d after and mailed questionnaire 30 d after colonoscopy Guaiac
FOBT49 30 d 243 10 30 0 Gotland, Sweden (19) 2984 Hospital admission data Guaiac
FOBT40 30 d 100 10 140 0 Note: FIT = fecal immunochemical test, FOBT = fecal occult blood test, NR = not reported, SAE = serious adverse event.
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