Colonic neoplasia in patients with nonspecific GI symptoms

Gastrointest Endosc. 2000 Jun;51(6):647-51. doi: 10.1067/mge.2000.105082.


Background: The purpose of this study was to determine the prevalence rate of colonic polyps or masses 1 cm or greater in diameter in patients with nonspecific abdominal symptoms, from diverse practice settings, using a national endoscopic database.

Methods: Consecutive patients undergoing colonoscopy were included based on procedure indication. Endoscopic data were generated with a computer database at each practice site, transmitted to a central data bank and merged with data from multiple sites for analysis. Group 1 patients had nonspecific abdominal symptoms, which were defined as pain, constipation and diarrhea. Group 2 patients had a positive fecal occult blood test. Group 3 patients were asymptomatic, undergoing screening colonoscopy. Serious colon pathology was defined as a polyp or mass greater than 9 mm in size.

Results: Data were collected from 31 practice sites in 21 states during a period of 18 months. Of the 20,745 colonoscopy examinations, 9.2% were performed to evaluate patients with nonspecific abdominal symptoms, excluding other indications. Among patients with nonspecific symptoms 7.27% had polyp(s) 1 cm or greater in diameter compared with 17.05% of patients with positive fecal occult blood test (odds ratio 2.12: CI [1.73, 2.60]; p < 0.001). Patients with nonspecific symptoms had similar rates of large polyps as asymptomatic patients (7.27% vs. 6.45%, p = 0.32). Multivariate analysis identified several independent variables including increasing age, male gender and practice site at a Veterans Affairs Medical Center.

Conclusions: In diverse, practice-based settings, patients with nonspecific abdominal symptoms who are referred for colonoscopy do not have a higher risk of serious colonic pathology than asymptomatic patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Pain / diagnosis*
  • Adult
  • Aged
  • Colonic Neoplasms / diagnosis*
  • Colonic Neoplasms / epidemiology
  • Constipation / diagnosis*
  • Databases, Factual
  • Diarrhea / diagnosis*
  • Female
  • Humans
  • Intestinal Polyps / diagnosis
  • Intestinal Polyps / epidemiology
  • Male
  • Middle Aged
  • Prevalence