To characterise the colonoscopies performed in the Portuguese District Hospitals.
Transverse study conducted between 7 and 18 March 2005 amongst the 33 District Hospitals throughout Portugal. Data collected included the following: gender, age, geographical origin, ambulatory or hospitalised, routine or emergency, type of preparation, sedation practice (if any), informed consent, indication, extent of the visualisation of the colon and final result (endoscopic and histological).
Thirty-one of the 33 District Hospitals (94%) sent the reports of colonoscopies and biopsies performed during the aforementioned period, resulting in 1245 colonoscopies. The majority of colonoscopies were ambulatory (80.7%); in 12 centres informed consent was obtained. The main indications were the following: polipectomy (20%), haematochezia (15%) and polyp follow-up (10%), whereas screening for colorectal cancer was the sixth most frequent indication. Sedation was administered in 24.5% of procedures. Colonoscopies were complete in 69.6% of cases. The main reasons for incomplete colonoscopies were poor bowel preparation, patient discomfort or technical difficulty. Colonoscopies were normal in 36% of cases; 40.3% had polyps, 16.4% had diverticulosis, 4.8% had colorectal cancer, 3.5% had inflammatory bowel disease and 1.1% had angiodisplasias.
There was a high interest in participating in this study by Endoscopy Units in Portuguese District Hospitals. There is a low number of units using informed consent, which is mandatory by law, and this should be corrected. There is a need to increase sedation practice and to find better ways for preparing the colon, in order to achieve a higher percentage of complete colonoscopies and of polypectomies. The numbers of polyps detected and of colorectal cancers diagnosed confirm the importance of screening for colorectal cancer.