Colonoscopic yield of colorectal neoplasia in daily clinical practice

Table 1 Indication cluster definition

Indication cluster (n; %)	Consists of the following indications
G-I bleeding (696; 15)	Hematochezia and/or melena
Anemia (356; 8)	Any kind of anemia
CRC suspicion (204; 4)	Clinical and/or radiological suspicion CRC
Weight loss (101; 2)	Weight loss
Family history CRC1 (447; 10)	Any family history of CRC or screening
IBS (969; 21)	Abdominal pain, change in bowel habits, bloating, diarrhea, constipation
IBD exacerbation (256; 6)	Clinical suspicion IBD and/or endoscopic evaluation of IBD exacerbation
CRC surveillance (454; 10)	Follow up after CRC
Polyp surveillance (583; 13)	Follow up after polypectomy
IBD surveillance (142; 3)	Surveillance for dysplasia in IBD
FAP/HNPCC surveillance (84; 2)	Screening and/or surveillance in FAP/HNPCC families
Other/non-specified (331; 7)	No indication mentioned, ileus and desufflation therapy, fecal incontinence, monitoring diverticulitis after treatment, tenesmus, endoscopic treatment radiation enteritis

¹Known hereditary CRC syndromes like HNPCC, FAP or MYH-polyposis are excluded. Note 1: The number of patients included in both study objectives was 4623 patients; Note 2: Within the indication cluster, the numbers and percentages of patients are placed between brackets.

Table 2 Yield of advanced neoplasia per indication in all complete colonoscopies n (%)

Indication cluster	Right-sided advanced neoplasia	Left-sided advanced neoplasia	Synchronous left- and right-sided advanced neoplasia	Total number of patients with advanced neoplasia
G-I bleeding (n = 696)	19 (11)	146 (83)	11 (6)	176 (25)
Anemia (n = 356)	35 (57)	21 (34)	5 (8)	61 (17)
CRC suspicion (n = 204)	29 (33)	54 (61)	6 (7)	89 (44)
Weight loss (n = 101)	2 (22)	7 (78)	0	9 (9)
Family history CRC1 (n = 447)	10 (30)	19 (58)	4 (12)	33 (7)
IBS (n = 969)	22 (26)	57 (66)	7 (8)	86 (9)
IBD exacerbation (n = 256)	1 (33)	2 (67)	0	3 (1)
CRC surveillance (n = 454)	11 (29)	23 (60)	4 (11)	38 (8)
Polyp surveillance (n = 583)	29 (41)	36 (51)	6 (8)	71 (12)
IBD surveillance (n = 142)	3 (43)	4 (57)	0	7 (5)
FAP/HNPCC surveillance (n = 84)	2 (25)	5 (63)	1 (13)	8 (10)
Other/Non-specified2 (n = 331)	20 (48)	21 (50)	1 (2)	42 (13)
Total (n = 4623)	183 (29)	395 (63)	45 (7)	623 (13)

¹Known hereditary CRC syndromes like HNPCC, FAP or MYH-polyposis are excluded;

²Including no indication mentioned, ileus and desufflation therapy, fecal incontinence, monitoring diverticulitis after treatment, tenesmus and endoscopic treatment radiation enteritis. NB: Within the indication cluster, the numbers of patients are placed between brackets.

Table 3 Prevalence and distribution of advanced colorectal neoplasia in 4623 patients n (%)

Localization in the colo-rectum	CRC	Advanced adenoma	Advanced neoplasia1
Rectum	86 (31)	74 (22)	160 (26)
Sigmoid	77 (27)	131 (38)	208 (33)
Descending colon	19 (7)	29 (8)	48 (8)
Transverse colon	23 (8)	19 (6)	42 (7)
Ascending colon	37 (13)	46 (13)	83 (13)
Caecum	39 (14)	43 (13)	82 (13)
Total	281 (100)	342 (100)	623 (100)

¹Advanced neoplasia was defined as an adenoma > 1.0 cm and/or > 25% of villous architecture and/or high-grade dysplasia or cancer; In two patients, two CRC’s were found. In one case, both were located in the distal colon. In the other case, a distal and a proximal tumor was found; In 45 patients, both proximally and distally located advanced neoplasia were found.