Screening Colonoscopy in Port Harcourt, Nigeria

Colonoscopy is a screening tool for colorectal cancer. The cost of this service, ready availability and expertise are factors limiting its routine use in low-/middle-income countries. The aim was to study premalignant colonic polyps in asymptomatic middle-aged Nigerians and highlight the usefulness of screening colonoscopy in a sub-Saharan African population. We carried out an observational study on asymptomatic patients undergoing screening colonoscopy in a referral endoscopy facility in Port Harcourt, Rivers State, Nigeria from January to December 2018. The variables collated were demographics, endoscopic and histologic findings. Statistical analysis was done using IBM SPSS Statistics for Windows, version 20 Armonk, NY. A total of 144 colonoscopy procedures were performed during the study period with 70 asymptomatic cases for screening indication. Sixty-five were males and 5 females. The age range was from 48 years to 60 years; mean 54.8 ± 3.6 years. A polyp-detection rate of 53.7% was recorded with multiple polyps seen in 13 cases. Adenoma(s) detected in 19 persons were: 22 tubular adenomas with low grade dysplasia; 3 tubulo-villous adenomas with low grade dysplasia; 1 sessile serrated adenoma. The adenoma detection rate was 28.8%. No abnormality was detected in 19 cases. There is a worrisome prevalence of adenomatous polyps; villous adenoma is rare. A targeted policy of screening and surveillance by colonoscopy will curb the rising incidence of colorectal cancer.