Open AccessAPPROPRIATENESS OF REFERRING FOR COLONOSCOPY: RESULTS FROM A CROSS–SECTIONAL STUDY IN PRIMARY CARE
Author(s) -
Núria Sánchez-Ruano,
Amparo Hervás,
Josep Vilaseca
Publication year - 2021
Publication title -
medical science pulse
Language(s) - English
Resource type - Journals
eISSN - 2544-1620
pISSN - 2544-1558
DOI - 10.5604/01.3001.0014.8693
Subject(s) - medicine , colonoscopy , diverticulosis , colorectal cancer , referral , dysplasia , adenoma , family history , hemorrhoids , hyperplastic polyp , gastroenterology , cross sectional study , cancer , general surgery , pathology , family medicine
Background:Colorectal cancer (CRC) is the third most commonly diagnosed malignant cancer and the fourth leading cause of cancer-related death in the world. The role of family doctors in the diagnosis and management of gastrointestinal disorders, including screening for CRC, is crucial.Aim of the study:To examine the appropriateness of colonoscopy referrals in a primary healthcare setting.Material and methods:The clinical reports of all colonoscopies ordered during 2017 at a primary care center (317 in total) were examined. The reasons for referral, the findings of the colonoscopies, and the pathology of identified polyps were extracted from the reports and summarized.Results:The patients included 161 males (50.8%) and 156 females (49.2%) with a mean age of 63.6 years. The most frequent reasons for ordering a colonoscopy were a personal history of polyposis/CRC (n = 94, 29.7%), rectal bleeding (n = 57, 18%) and anemia (n = 35, 11%). Only 67 (21%) of the colonoscopies performed showed a normal result, whereas 250 (79%) had abnormal findings. The main findings of the colonoscopies were polyps (n = 119, 37.5%), diverticulosis (n = 61, 19.2%) and hemorrhoids (n = 37, 11.7%). The main results for polyp pathology were tubular adenoma with low-grade dysplasia (n = 70, 58.8%), hyperplastic polyp (n = 27, 22.7%), adenocarcinoma (n = 9, 7.6%) and inflammatory polyp (n = 4, 3.4%). Colorectal cancer was found in a total of 14 (4.4%) Conclusions: patients.The referral for colonoscopy by family doctors is appropriate.