Consider colonoscopy for young patients with hematochezia

Although a significant proportion of patients in this study was evaluated at a tertiary referral center, we believe that referral bias did not strongly influence the results of this study. Most endoscopic referrals originate from primary care providers within the University of Utah’s health care system. Furthermore, VA patients comprised approximately one fourth of the subjects, and VA patients typically receive all of their care within the VA Medical Center.

Because of the small numbers of patients in this study, it is difficult to conclude whether colonoscopy or flexible sigmoidoscopy is warranted in this patient population. However, based on current available evidence, we would strongly recommend consideration of colonoscopy in this patient population. Certainly, a large, prospective trial would be needed to answer the question of whether colonoscopy or flexible sigmoidoscopy is the appropriate test for patients younger than 50 years who present with rectal bleeding.

Corresponding author
Scott K. Kuwada, MD, Division of Gastroenterology, 4R-118 SOM, University of Utah Medical Center, 50 North Medical Drive, Salt Lake City, UT 84132. E-mail: Scott.Kuwada@hci.utah.edu.