Abstract
Over a 4-year period, a direct-access fibreoptic sigmoidoscopy service was evaluated prospectively. In all, 756 patients were referred (median age 58 years, range 18-91 years). The principal indications were rectal bleeding (45%) or change of bowel habit (28%); both features were present in 13%. Abnormalities were present in 68% of examinations. Major disease was identified in 22% (carcinoma 7.0%, adenoma 6.3%, inflammatory bowel disease 8.3%) and minor disease in 53% (haemorrhoids 36.8%, severe diverticular disease 10.9%, non-adenomatous polyp 3.4%, perianal disease 1.4%). In patients under 40 years of age, major disease was rare (one carcinoma, three adenomas). Of the patients, 21% underwent barium enema for incomplete examination or suspected additional disease. No additional major disease was identified, but one carcinoma found in a patient with stricture. These data show that a direct-access fibreoptic sigmoidoscopy service produces a high diagnostic yield and may be of value to both patients and general practitioners in expediting a clinical colorectal service.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Atkin W. S., Cuzick J., Northover J. M., Whynes D. K. Prevention of colorectal cancer by once-only sigmoidoscopy. Lancet. 1993 Mar 20;341(8847):736–740. doi: 10.1016/0140-6736(93)90499-7. [DOI] [PubMed] [Google Scholar]
- Hardcastle J. D., Pye G. Screening for colorectal cancer: a critical review. World J Surg. 1989 Jan-Feb;13(1):38–44. doi: 10.1007/BF01671152. [DOI] [PubMed] [Google Scholar]
- Hardcastle J. D., Thomas W. M., Chamberlain J., Pye G., Sheffield J., James P. D., Balfour T. W., Amar S. S., Armitage N. C., Moss S. M. Randomised, controlled trial of faecal occult blood screening for colorectal cancer. Results for first 107,349 subjects. Lancet. 1989 May 27;1(8648):1160–1164. doi: 10.1016/s0140-6736(89)92750-5. [DOI] [PubMed] [Google Scholar]
- Jensen J., Kewenter J., Asztély M., Lycke G., Wojciechowski J. Double contrast barium enema and flexible rectosigmoidoscopy: a reliable diagnostic combination for detection of colorectal neoplasm. Br J Surg. 1990 Mar;77(3):270–272. doi: 10.1002/bjs.1800770311. [DOI] [PubMed] [Google Scholar]
- Kalra L., Price W. R., Jones B. J., Hamlyn A. N. Open access fibresigmoidoscopy: a comparative audit of efficacy. Br Med J (Clin Res Ed) 1988 Apr 16;296(6629):1095–1096. doi: 10.1136/bmj.296.6629.1095. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marks G., Boggs H. W., Castro A. F., Gathright J. B., Ray J. E., Salvati E. Sigmoidoscopic examinations with rigid and flexible fiberoptic sigmoidoscopes in the surgeon's office: a comparative prospective study of effectiveness in 1,012 cases. Dis Colon Rectum. 1979 Apr;22(3):162–168. doi: 10.1007/BF02586809. [DOI] [PubMed] [Google Scholar]
- Morgan G. F. Open access radiology services: availability to general practitioners in the UK. Br Med J (Clin Res Ed) 1985 Oct 26;291(6503):1175–1176. doi: 10.1136/bmj.291.6503.1175. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nichols S. General practitioners' awareness of colorectal cancer. Br Med J (Clin Res Ed) 1986 Feb 1;292(6516):308–310. [PMC free article] [PubMed] [Google Scholar]
- Vellacott K. D., Roe A. M., Mortensen N. J. An evaluation of a direct access flexible fibreoptic sigmoidoscopy service. Ann R Coll Surg Engl. 1987 Jul;69(4):149–152. [PMC free article] [PubMed] [Google Scholar]