Colonoscopy-Related Adverse Events in the 21st Century - AJG 2026

The global incidence of colonoscopy-related adverse events (AEs) was analysed through a comprehensive meta-analysis of 82 population-based studies involving 38.5 million colonoscopies across 24 countries. The study categorised AEs into gastrointestinal and nongastrointestinal events. Gastrointestinal AEs included perforation (5.15 per 10,000 procedures), bleeding (18.39 per 10,000), and splenic injury (0.61 per 10,000). Nongastrointestinal AEs included cardiovascular events (52.11 per 10,000), respiratory events (4.26 per 10,000), and deaths (0.18 per 10,000). Despite the low overall risk, the findings emphasise the need for ongoing efforts to improve the safety of colonoscopy procedures. Subgroup analyses revealed some variability based on factors such as study design, region, and sample size. Most studies included in the analysis demonstrated a low to moderate risk of bias.