Adverse Effects Uncommon Following Colonoscopy

A new study provides further evidence on the safety of both screening and nonscreening colonoscopies in routine practice.

Researchers at the German Cancer Research Center (DKFZ; Heidelberg, Germany) evaluated data of over 30,000 individuals insured with the German statutory health insurance (AOK) who had undergone outpatient colonoscopy between 2001 and 2008; a control group consisted of insured persons who had not had a screening test. The researchers analyzed the incidence of serious adverse events (AEs) such as intestinal wall injuries, intestinal or splenic bleeding, myocardial infarction (MI), stroke, and overall mortality. The period for evaluation included 30 days following the colonoscopy in order to include possible late effects.

The results showed that the incidence of perforation was 0.8 per 1,000 screening and nonscreening colonoscopies. Hospitalizations because of bleeding occurred in 0.5 per 1,000 screening and nonscreening colonoscopies. The incidence of MI, stroke, and other nongastrointestinal AEs was similar in colonoscopy and control groups; no splenic injury was observed. Participants with AEs generally had a higher mean age and comorbidity rate than the overall study population. The study was published in the March 2013 issue of Gastrointestinal Endoscopy.

“For an examination offered to large portions of the population, the question of safety is of central importance. Therefore, it is equally important that physicians and public health experts are very well informed about the risks of complications,” said senior author Prof. Hermann Brenner, MD. “Only then can they profoundly evaluate chances and risks of a colonoscopy with their patients.”

Colon cancer is the second most common cancer in in Germany and the second most common cause of cancer-related death. Approximately 65,000 people are newly diagnosed with colorectal cancer every year and 26,000 people succumbed to the disease in 2010. Since 2002, colonoscopy is part of the national statutory cancer screening program in Germany for all insured persons aged 55 or older, but only one fifth of those eligible actually make use of the screening program. The reasons for this are manifold, including fear of a frightening diagnosis and of a potentially unpleasant examination, which can also lead to complications.

Related Links:
German Cancer Research Center