PWE-027 The Reasons for Gender Differences in Caecal Intubation Rates – Analysis of 8324 Colonoscopies Over 6 Years

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Abstract

Introduction

In 2012 we presented a poster to the Digestive Disorders Foundation Meeting, we analysed 5162 colonoscopies and noted a significant difference in caecal intubation rates (CIR) of male and female patients (92.73% v 87.63%, p < 0.0001, NNH 19.57).1

Introduction

Gender differences in colonoscopy have been published previously in the 1990s.2,3 Several theories were mooted for this difference; such as female patients undergoing previous hysterectomy,2 and having longer colons.3 We have revisited this topic to identify causes of the difference relevant to modern colonoscopic practice.

Methods

Data was analysed from 8324 colonoscopies at Kettering General Hospital 2008–13. Incomplete colonoscopies’ reports were scrutinised to record the causes of failure.

Results

Reason for failed colonoscopy (females v males, p value)

Results

Poor bowel preparation (16.38 vs. 24.66%, 0.09), tight bend (6.21 vs. 0.91%, <0.03)

Results

Intolerance/pain (27.97 vs. 19.63%, 0.11), looping (18.36 vs. 18.72%)

Results

Obstructing lesion (8.19 vs. 15.53%, 0.06), previous surgery (5.37 vs. 0.46%, <0.03)

Results

Diverticular disease (9.32 vs. 5.02%, 0.18), withdrew consent (5.93 vs. 2.28%, 0.14)

Conclusion

The data reveals significant differences in CIR between female and male patients (90.89 vs. 95.07%, p < 0.0001, NNH 24). Analysis of the reasons recorded for failure shows a strong trend in males for poor bowel preparation and obstructing lesion. In females, a strong trend was shown for pain/intolerance, diverticular disease and withdrawal of consent. Statistical significance was shown for previous (abdominal) surgery and tight bend. Looping is a common reason for failing colonoscopy with no gender difference.

Conclusion

This is an important observation that females are significantly less likely to have complete colonoscopy. Perhaps endoscopy units should outline the potential for missed lesions as a consequence when consenting female patients – in particular those with known diverticular disease or previous abdominal surgery. Other reasons of failure could also be addressed e.g. higher doses of analgesia for females as required.

Disclosure of Interest

None Declared.

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