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COLONOSCOPY DEMOGRAPHICS, INDICATIONS, AND FINDINGS IN AN EGYPTIAN COHORT: A PROSPECTIVE OBSERVATIONAL SINGLE CENTER STUDY
Ahmad a. Madkour^*2, Hamdy Ghanem², Mohammed Elfayoumie³, Mohammad A. Khaskia⁴, Mohamed A. Amer⁵, Ahmad F. Aboelezz¹, Reda N. AL-Sennary⁶, Ramy G. Abdel Hamed⁶, Elhosin Rageh⁶, Karim A. Kouta⁶, Muhammad Elsergany⁶, Kirollus Abdallah², Yehia Ahmed², Esraa A. Zakaria², ahmad h. salem^7
1Internal Medicine, Tanta University Faculty of Medicine, Tanta, Egypt; ²Helwan University, Helwan, Cairo, Egypt; ³Al Azhar University, Cairo, Egypt; ⁴Ain Shams University Faculty of Medicine, Cairo, Egypt; ⁵Nasser Institute for Research and Treatment, Cairo, Egypt; ⁶El Shefaa Medical Complex, Portsaid, Egypt; ⁷Egypt Healthcare Authority, Portsaid, Egypt

Background and Aims:
Colonoscopy is a cornerstone for diagnosing and managing gastrointestinal diseases, yet data on its utilization patterns and clinical outcomes in Middle Eastern populations are limited. This prospective study provides a large-scale analysis of colonoscopy demographics, clinical indications, findings, and pathological outcomes in an Egyptian cohort.

Methods:
A total of 1022 patients (mean age: 51.7 ± 16.8 years; 52.5% male) undergoing colonoscopy from January 10, 2022, to November 6, 2024, were enrolled. Data were collected prospectively, including patient demographics, indications for colonoscopy, endoscopic findings, and histopathological results. Statistical analysis was performed using Python 3 on Google Colaboratory.

Results:
Among the 1022 patients, colonoscopy was predominantly performed for screening (28.96%), gastrointestinal bleeding (22.31%), and abdominal pain (18.8%). Changes in bowel habits (15.75%) and anemia (10.5%) were significant secondary indications. Endoscopic lesions were detected in 78.9% of patients, with internal hemorrhoids (40.9%) being the most prevalent finding, followed by polyps (22.1%), non-specific colitis (10.2%), masses (8.2%), and inflammatory bowel disease (2.5%).

Polyps were predominantly located in the rectum (6.7%) and transverse colon (5.1%), with a median patient age of 59 years (IQR: 46.25–67). Histopathological analysis revealed predominantly benign lesions, including hyperplastic polyps (12.9%) and inflammatory polyps (1.4%). Adenomatous polyps were detected in 9% of patients, of which 25.7% exhibited high-grade dysplasia. Colorectal masses were detected in 8.2% of patients, with a median patient age of 61 years (IQR: 49–69). Alarmingly, adenocarcinoma accounted for 6.3% of all patients and 73.3% of identified masses. Rectal bleeding (32.1%), anemia (21.4%), and radiological abnormalities (17.9%) were the top indications for patients presenting with masses. Screening colonoscopy identified 38 cases of masses, emphasizing its life-saving potential.

Other findings included diverticulosis (8%), angiodysplasia (1.4%), and telangiectasia (1.3%). Neoplasms disproportionately affected patients aged 60 and older, underscoring the critical importance of Egypt’s screening protocols for this vulnerable population.

Conclusion:
This study provides a comprehensive analysis of colonoscopy demographics, indications, and findings in an Egyptian cohort. Additionally, it highlights the significant burden of polyps and colorectal cancer, with a high adenocarcinoma prevalence. This emphasizes the importance of early detection to improve the health and reduce gastrointestinal morbidity and mortality in the region.

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