Screening colonoscopy in asymptomatic average-risk persons with negative fecal occult blood tests

Abstract

Colonoscopy was performed on 210 asymptomatic average-risk persons, aged 50–75 years, who had negative fecal occult blood test results. Colonoscopy was complete to the cecum in 209 subjects. Fifty-three subjects (25%) had adenomas and two had cancer. All of the adenomas ≥1 cm in size and both cancers occurred in subjects aged ≥60 years. Fifty-one percent of subjects with adenomas and one with cancer had no neoplasms distal to the sigmoid-descending colon junction. One subject had a major postpolypectomy hemorrhage that stopped spontaneously. Screening colonoscopy, therefore, has a high yield for detection of neoplasms in asymptomatic average-risk persons aged ≥60 years with negative fecal occult blood test results. The yield is low in persons aged 50–54 years and intermediate in persons aged 55–59 years.