Theodore R. Levin, MD; Wei Zhao, MPH; Carol Conell, PhD; Laura C. Seeff, MD; Diane L. Manninen, PhD; Jean A. Shapiro, PhD; Jane Schulman, PhD
Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
Acknowledgments: The authors thank Patricia Leighton for providing able project management, Alice Moore for performing medical records analysis, and Jocelyne Miller, MD, for collaborating in the adjudication of causes of hospitalizations.
Grant Support: Centers for Disease Control and Prevention (contract number GS-23F-8167H; task order number MC2-06).
Potential Financial Conflicts of Interest: None disclosed.
Request for Single Reprints: Theodore R. Levin, MD, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612; e-mail, Theodore.Levin@kp.org.
Current Author Addresses: Drs. Levin and Conell and Ms. Zhao: Kaiser Permanente, 2000 Broadway, Oakland, CA 94612.
Drs. Manninen and Schulman: Battelle Memorial Institute, 1100 Dexter Avenue North, Seattle, WA 98109.
Dr. Schulman: Battelle Memorial Institute, Crystal City, VA.
Drs. Seeff and Shapiro: Centers for Disease Control and Prevention, MS K-55, Atlanta, GA 30341.
Author Contributions: Conception and design: T.R. Levin, L.C. Seeff, J.A. Shapiro, D.L. Manninen.
Analysis and interpretation of the data: T.R. Levin, W. Zhao, C. Conell, L.C. Seeff, J.A. Shapiro, D.L. Manninen.
Drafting of the article: T.R. Levin, C. Conell, L.C. Seeff, D.L. Manninen.
Critical revision of the article for important intellectual content: T.R. Levin, W. Zhao, L.C. Seeff, J.A. Shapiro, J. Schulman.
Final approval of the article: T.R. Levin, W. Zhao, L.C. Seeff, J.A. Shapiro.
Statistical expertise: C. Conell, J. Schulman.
Obtaining of funding: T.R. Levin, L.C. Seeff, J.A. Shapiro.
Collection and assembly of data: W. Zhao, C. Conell.
Levin TR, Zhao W, Conell C, Seeff LC, Manninen DL, Shapiro JA, et al. Complications of Colonoscopy in an Integrated Health Care Delivery System. Ann Intern Med. 2006;145:880-886. doi: 10.7326/0003-4819-145-12-200612190-00004
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Published: Ann Intern Med. 2006;145(12):880-886.
Colonoscopy is the final step in colorectal cancer screening, regardless of the initial test chosen, and is recommended for primary colorectal cancer screening in average- risk persons (1-4). Colorectal cancer screening targets apparently healthy people; therefore, the magnitude of the risk and severity of the harms from screening are important issues to consider when selecting a screening strategy (5). Described complications of colonoscopy include colonic perforation, postbiopsy and postpolypectomy bleeding, and postpolypectomy syndrome (a transmural colonic burn, marked by localized abdominal pain without evidence of frank perforation) (6). Diverticulitis, which is caused by a microscopic perforation of the colon, can also theoretically be caused by colonoscopy in persons with preexisting diverticulosis.
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