Appropriateness of indication and diagnostic yield of colonoscopy: First report based on the 2000 guidelines of the American Society for Gastrointestinal Endoscopy

Table 2 Indications for colonoscopy among 468 patients referred for reasons generally indicated according to the 2000 ASGE guidelines¹

Indication	n (%)
1 Hematochezia	151 (20.5)
2 Clinically significant diarrhea of unexplained origin	65(8.8)
3 Irritable bowel syndrome or chronic abdominal pain: colonoscopy done once to rule out organic disease	48(6.5)
4 Chronic inflammatory bowel disease of the colon, if more precise diagnosis or determination of the extent of activity of disease will influence immediate management	34 (4.6)
5 Unexplained iron deficiency anemia	27 (3.7)
6 Following adequate clearance of neoplastic polyp(s) survey at 3-5 year intervals	24 (3.3)
7 Colonoscopy to remove synchronous neoplastic lesions at or around time of curative resection of cancer followed by colonoscopy at 3 years and 3-5 years thereafter to detect metachronous cancer	23 (3.1)
8 Evaluation of an abnormality on barium enema or other imaging study, which is likely to be clinically significant, such as a filling defect or stricture	19 (2.6)
9 Presence of fecal occult blood	12 (1.6)
10 Examination to evaluate the entire colon for synchronous cancer or neoplastic polyps in a patient with treatable cancer or neoplastic polyp	11 (1.5)
11 Excision of colonic polyp	9 (1.2)
12 Balloon dilation of stenotic lesions (e.g., anastomotic strictures)	9 (1.2)
13 Melena after an upper GI source has been excluded	8 (1.1)
14 In patients with ulcerative or Crohn's pancolitis eight or more years' duration or left sided colitis 15 or more years' duration every 1-2 years with systematic biopsies to detect dysplasia	8 (1.1)
15 Treatment of bleeding from such lesions as vascular malformation, ulceration, neoplasia, and polypectomy site (e.g., electrocoagulation, heater probe, laser or injection therapy)	7 (1.0)
16 Family history of sporadic colorectal cancer before the age of 60: colonoscopy every 5 years beginning at the age of 10 years earlier than the affected relative or every three years if adenoma is found	6 (0.8)
17 Intraoperative identification of a lesion not apparent at surgery (e.g., polypectomy site, location of a bleeding site)	3 (0.4)
18 Family history of hereditary non-polyposis colorectal cancer: colonoscopy every two years beginning at the age of 25, or five years younger than the earliest age of diagnosis of colorectal cancer. Annual colonoscopy beginning at the age of 40	2 (0.3)
19 Palliative treatment of stenosing or bleeding neoplasms (e.g., laser, electrocoagulation, stenting)	2 (0.3)

¹According to 2000 American Society for Gastrointestinal Endoscopy (ASGE) guidelines on appropriate use of gastrointestinal endoscopy[9].