First Colonoscopy of the Day Finds More Polyps

News from Digestive Disease Week 2008

Video courtesy of Medscape Today.

The first colonoscopy performed each day finds more polyps — both small hyperplastic ones and more serious advanced adenomas.  As the day goes on, fewer polyps are found every hour.

Researchers studied all the colonoscopies performed at the UCLA Veteran Administration Center in 2006 and 2007, keeping track of a number of variables that might affect the number of polyps found.  Even adjusting for patient differences, withdrawal times, and bowel preparation, the time of day remained a predictor of how many polyps were located during the colonoscopy.

Over 500 colonoscopies were performed, both for colorectal cancer screening and to evaluate symptoms.  At least one polyp was found in 71 percent of people studied.  The first case of the day yielded an average of 2.1 polyps, later cases averaged 1.6.

The research team explored a number of variables to explain the difference including:

• Whether the colonoscopy was for screening, surveillance, or diagnosis.
• The age, race, gender, and body mass index of the patient.
• Whether patients had a family or personal history of previous polyps or had a prior colonoscopy or flexible sigmoidoscopy.
• How long it took to withdraw the colonoscope.
• Whether the cecum was reached.
• The quality of bowel preparation.
• Type of polyp — hyperplastic or advanced adenomas

Even accounting for these variable, time of day remained significant.

Digestive Disease Week is the annual gathering of physicians and researchers in the fields of gastroenterology, hepatology, endoscopy, and gastrointestinal surgery.  It is being held this year in San Diego.