Patients aged 55 years or above who have undergone appendicectomy should be offered colonoscopy to exclude co-existent caecal pathology, a new study has concluded.
The research retrospectively collected data from 1633 patients aged 40 years and above who underwent appendicectomy in a 10-year period, from 1 January 2004 to 31 December 2014.
A total of 1055 (64%) patients had histological confirmation of acute appendicitis, of whom 603 patients (57%) were aged 40-54 years and 452 patients (43%) were aged 55 years or above.
Of 26 (2.5%) patients investigated post-appendicectomy, 3 (11.5%) had caecal pathology (2 adenocarcinoma, 1 benign caecal polyp). Ten (2.2%) patients aged 55 years or over had caecal pathology. Seven (1.6%) were diagnosed with caecal cancer. No patients below age 54 years were diagnosed with caecal cancer.
The incidence of caecal cancer in the overall population was 0.66%. Patients aged 55 years or above were more likely to develop caecal pathology than patients aged 40-54 years (P=.006). The odds ratio of developing caecal pathology was 6.8 times greater (95% CI, 1.49-31.29) in people aged 55 years and over.
The authors said: “Our results would support the recommendation that follow-up with colonoscopy in post-appendicectomy patients aged over 55 years would contribute to earlier detection of colorectal pathology.”
However, they point out that this is a single-centre study and generalisability to a wider UK population must be considered. A prospective, multi-centre study across the United Kingdom would provide the much-needed guidance, they said.
