Assessment of colonoscopy yield in the detection of colonic neoplasms

Czech version

Authors: S. Weisová ^1,2; T. Koller ¹; M. Weis ³
Authors‘ workplace: V. interná klinika Lekárskej fakulty UK v Bratislave ¹; IV. interná klinika LF UK a UN Bratislava, Nemocnica sv. Cyrila a Metoda ²; Gastroenterologická ambulancia, Levice ³
Published in: Gastroent Hepatol 2026; 80(5): 370-374
Category: Gastrointestinal Oncology: Original Article
doi: https://doi.org/10.48095/ccgh2026370

Overview

Background and aim: Colorectal cancer (CRC) is one of the most common malignancies representing a significant healthcare and socioeconomic burden. Despite the implementation of an organized screening program in Slovakia, participation of the target population remains low, limiting its effectiveness in clinical practice. Colonoscopy is a key method for CRC screening and diagnosis, as it enables not only the detection but also the removal of precancerous lesions. The aim of this study was to evaluate the colonoscopy yield in the detection of colorectal neoplasms and to analyze selected factors associated with its diagnostic yield.

Patients and methods: Data from 300 patients who underwent colonoscopy at a single outpatient gastroenterology clinic between 2019 and 2023 were retrospectively analyzed. All examinations were performed by a single endoscopist. Demographic and medical history data, fecal immunochemical test (FIT) results, bowel preparation quality, and endoscopic and histopathological findings were evaluated. Main outcomes included polyp detection rate, detection of adenomatous lesions, and colorectal cancer detection rate.

Results: A positive FIT result was recorded in 181 out of 300 patients (60.3%), while 119 patients (39.7%) underwent primary colonoscopy. Adenoma detection rate (ADR) was 47.9% in the primary colonoscopy group and 46.4% in the FIT--positive group, with no statistically significant difference between the groups (P = 0.814). Colorectal cancer was diagnosed in 27 patients (9.0%), with a significantly higher detection rate in the FIT-positive group (14.4 vs. 0.8%; P < 0.001).

Conclusion: The results highlight the importance of colonoscopy in the detection of colorectal neoplasms. When interpreting detection indicators, the indication for colonoscopy and FIT results should be taken into account, as patients with a positive FIT represent a population with a higher probability of colorectal neoplasia. Separate evaluation of results according to FIT status allows for a more accurate assessment of the diagnostic yield of colonoscopy.

Keywords:

screening – colonoscopy – colorectal cancer – adenoma – adenoma detection rate – diagnostic yield

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