Colonoscopy Screening: An Optimal Early Diagnostic Choice for Colorectal Symptoms

Background: Colorectal cancer (CRC) is an emerging public health challenge in Bangladesh, with increasing incidence due to lifestyle changes, dietary habits, and genetic predisposition. Early detection significantly improves prognosis, yet colonoscopy remains underutilized due to limited awareness and accessibility. Implementing routine colonoscopic screening could enhance early diagnosis and reduce CRC-related mortality. Objective: This study aimed to evaluate the necessity and effectiveness of early colonoscopy screening as the preferred diagnostic method for colorectal symptoms in Bangladesh. Methods: The study was conducted at the Department of Colorectal Surgery, Tertiary Hospital, Dhaka, from January 2023 to June 2024. A total of 200 patients presenting with colorectal symptoms were included. Data were collected using a structured case record form, incorporating patient history, clinical findings, laboratory investigations, operative findings, and histopathological reports. Statistical analysis was performed using SPSS version 20. Results: Among the 200 participants, the majority were above 50 years old (5.5%), while 4.5% were between 41-50 years, and 0.5% were in the 31-40 age group. Malignancy was more prevalent in males (8%) than females (3%), with a male-to-female malignancy ratio of 1.7:1. The most common clinical presentation was per-rectal bleeding (64%), followed by anemia/weakness (46%), altered bowel habits (36%), pain (10.5%), and obstruction (3.5%). Colonoscopic findings revealed that 11% had malignancies, while 32% had benign conditions. A substantial proportion (38%) had normal findings, and 9% were follow-up cases. Malignancies were predominantly observed in patients aged 41 and above, with right-sided colon malignancies being more common in males than females. Conclusion: The study underscores the importance of implementing routine colonoscopy screenings in Bangladesh, particularly for high-risk groups. Ensuring the availability of colonoscopy