Incidence of colorectal premalignant and malignant neoplasm on colonoscopy in an in-patient setting.

e14185 Background: Colorectal cancer (CRC) continues to be a leading cause of death and the third most common cancer in both genders. Numerous studies have shown that routine screening for colon cancer reduces CRC incidence and mortality by detecting premalignant lesions early. Hence screening colonoscopy in the outpatient setting has been the standard of care. In contrast, the incidence of pre-malignant (PMN) and malignant neoplasms (MN) identified during a colonoscopy due to an acute presentation in an in-patient setting is currently unknown. We evaluate the incidence of PMN and MN lesions identified in patients that underwent in-patient colonoscopy for anemia, gastrointestinal bleed (GIB), and or abdominal pain. Methods: A retrospective review of all gastrointestinal consultations (GIC) from January 1st, 2009 until December 31st, 2009 at a single institution. GIC as determined by the requesting provider for anemia, abdominal pain, and/or gastrointestinal bleed (GIB) were included. Results: There were 291 GICs for anemia, abdominal pain, GIB, or a combination thereof resulting in 218 colonoscopies. A total of 15 (6.9%) PMN and MN lesions were identified. Pathological evaluation reveled 13 (86.7%) of these lesions to be consistent with that of adenocarcinoma. The remaining 2 showed squamous cell cancer morphology. PMN/MNs were identified in patients with GIB and anemia (46.7%), anemia alone (20%), GIB and abdominal pain (20%), and GIB alone (13.3%). There was no significant difference in lesions found between genders (46.7% male). Conclusions: Routine outpatient screening colonoscopy is the standard of care with the goal of resecting early stage cancerous lesions resulting in cure. However, there is paucity of data on the incidence of these lesions being identified in an in-patient setting where colonoscopy is performed for GI bleed, anemia, abdominal pain, or a combination thereof. We demonstrate that colonoscopy resulted in identification of PMN/MNs in a significant proportion of patients with afore mentioned specific complaints. Interestingly, most lesions were identified in patients with GIB and anemia, suggesting that a thorough evaluation be undertaken as it may herald an underlying neoplasm.