Characteristics and outcomes of patients undergoing colonoscopy in Gaza Strip hospitals: a retrospective study

Colonoscopy is a key diagnostic and therapeutic tool for colorectal diseases, including cancer, polyps, and bleeding disorders. In low-resource settings such as the Gaza Strip, challenges in access to healthcare may influence patient characteristics, indications, and outcomes of colonoscopy. Understanding these patterns is critical to improving diagnostic services and patient care. This retrospective analytical study was conducted at the endoscopy unit of Gaza Strip hospitals and included all patients who underwent colonoscopy between 2017 and 2022. A total of 983 patients were identified from hospital records. Data on sociodemographic characteristics, presenting complaints, colonoscopic findings, and physician recommendations were collected using a structured questionnaire. Statistical analysis was performed using SPSS v23, with descriptive and inferential methods applied. Among 983 patients undergoing colonoscopy (mean age 52 ± 16 years; 61.4% male), most procedures were outpatient (93.6%) and performed under general anesthesia (97.8%). The most common indications were bleeding (35.2%) and follow-up (15.9%). Colonoscopy reached the cecum in 46.7% of cases. Findings were normal in 35.4%, while masses (11.0%), polyps (10.2%), diverticulae (5.0%), and hemorrhoids (7.5%) were the most frequent abnormalities. Abnormal findings were significantly associated with older age, male sex, non-outpatient admission, and bleeding as indication (p < 0.01). Management reflected procedural outcomes: normal findings mainly required follow-up, whereas significant abnormalities were more often referred for medical or surgical intervention (p < 0.001). This study highlights that colonoscopy in Gaza Strip hospitals predominantly serves middle-aged male patients, with bleeding being the most common indication. While many patients had normal findings, a considerable proportion presented with polyps, masses, or other abnormalities requiring further management. These findings underscore the importance of colonoscopy as a diagnostic and preventive tool and emphasize the need to strengthen screening and early detection strategies in resource-limited settings.