SEARCH · PubMed Health

Results for “Sigmoidoscopy”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,045 records · Page 58Linked to original sources

PubMed2003

Colorectal cancer screening attitudes and behavior: a population-based study.

BACKGROUND: Even though colorectal cancer (CRC) screening tests for persons 50 years of age or over are recommended to reduce colorectal cancer mortality, screening rates remain disturbingly low. METHODS: Using random digit dialing, 355 telephone interviews were conducted with black and white men and women, 50-79 years of age, who resided in Genesee County, Michigan. The Health Belief Model provided the framework to assess attitudes and practices regarding CRC screening. RESULTS: For both endoscopic procedures, significantly higher percentages of whites than blacks were aware of the screening procedure (P < 0.05). Overall, fewer than 30% of respondents were adherent to current CRC screening guidelines. Adherence was lowest for black females: 21% for fecal occult blood test, 20% for flexible sigmoidoscopy, and 12% for colonoscopy. Black males compared to black females were about 2.8 times more likely to have had either flexible sigmoidoscopy or colonoscopy (P < 0.05). Physician recommendation was a powerful motivator to screening. Two consistent barriers to screening were the belief that: (a) the test is not needed; and (b) the test is embarrassing. CONCLUSIONS: Interventions directed at physicians and patients are essential to enhance CRC screening rates. CRC survival rates may be improved by physician-guided promotion of screening that focuses on identified barriers.

Aged↗

PubMed2004

Factors associated with colorectal cancer screening among Chinese-Americans.

OBJECTIVE: To investigate factors associated with receipt of colorectal cancer (CRC) screening among urban senior Chinese-Americans. METHODS: Two hundred three men and women from three senior centers completed a questionnaire that included sections on demographics, fecal occult blood testing (FOBT) and sigmoidoscopy use, and potential barriers to screening. RESULTS: Receipt of a FOBT within the prior 12 months (37.9% of sample) was associated with fewer years of US residency, lower level of worries or fears of test results, and higher level of perceived susceptibility to CRC. Receipt of a flexible sigmoidoscopy within the past 5 years (22.2% of sample) was associated with higher levels of education, lower levels of worries or fears of test results, and higher level of perceived susceptibility of CRC. CONCLUSIONS: Intervention programs may target these areas to facilitate CRC screening in Chinese-Americans so that national goals can be met for all Americans.

Aged↗

PubMedDate not supplied

Are hyperplastic rectosigmoid polyps associated with an increased risk of proximal colonic neoplasms?

Diminutive polyps are frequent findings on screening flexible sigmoidoscopy. To determine the significance of distal diminutive polyps, we conducted a prospective study of 162 asymptomatic, average-risk subjects who were 50 years of age or older. Subjects were divided into four groups: 42 control subjects with no polyps in the rectosigmoid, 66 subjects with at least one diminutive adenoma in the rectosigmoid, 12 subjects with a mixed hyperplastic-adenomatous polyp in the rectosigmoid, and 42 subjects with only hyperplastic polyps in the rectosigmoid. Total colonoscopy was performed on all subjects. The prevalence of proximal adenomas was 42% in the adenoma group, 25% in the mixed group, 14% in the hyperplastic group and 12% in the control group. The prevalence of proximal adenomas was significantly higher (p = 0.006) in the adenoma group as compared with the control and hyperplastic groups. Increasing age was associated with an increased prevalence of proximal adenomas. Nearly two thirds of those over 65 years of age with distal diminutive adenomas had proximal colonic neoplasms. These results indicate that diminutive rectosigmoid adenomas are good markers for proximal neoplasms. Rectosigmoid hyperplastic polyps are not associated with an increased prevalence of proximal neoplasms. Total colonoscopy is not indicated if hyperplastic polyps are the only finding on flexible sigmoidoscopy.

Aged↗

PubMed2003

A national survey of primary care physicians' colorectal cancer screening recommendations and practices.

BACKGROUND: National data on providers' colorectal cancer (CRC) screening knowledge, attitudes, and practices are sparse. This study assessed primary care physicians' (PCPs') beliefs about the effectiveness of CRC screening, their recommendations for screening, their perceptions of the influence of published guidelines on their CRC screening recommendations, and how they conduct CRC screening in their clinical practices. METHODS: A questionnaire was administered to a nationally representative sample of practicing PCPs. Of 1718 eligible physicians, 1235 (72%) responded. RESULTS: Only 2% of PCPs said they did not recommend CRC screening. Over 80% indicated that they most often recommend CRC screening with fecal occult blood testing and/or flexible sigmoidoscopy, although colonoscopy was perceived as the more effective screening modality. Nearly two-thirds of obstetrician/gynecologists and one-fourth of other practitioners reported conducting fecal occult blood testing exclusively by digital rectal exam. Only 29% of PCPs said they perform sigmoidoscopy. Estimated volumes of ordering, performing, or referring for CRC screening were low, and <20% reported that three-fourths or more of their older patients were up to date with CRC screening as recommended by the physician. Many PCPs reported recommending CRC screening at nonstandard starting ages or too-frequent intervals. CONCLUSIONS: Awareness of CRC screening among PCPs in the United States is high. However, knowledge gaps about the timing and frequency of screening and suboptimal screening delivery were evident.

Adult↗

PubMed2000

Design of the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial.

The objectives of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial are to determine in screenees ages 55-74 at entry whether screening with flexible sigmoidoscopy (60-cm sigmoidoscope) can reduce mortality from colorectal cancer, whether screening with chest X-ray can reduce mortality from lung cancer, whether screening men with digital rectal examination (DRE) plus serum prostate-specific antigen (PSA) can reduce mortality from prostate cancer, and whether screening women with CA125 and transvaginal ultrasound (TVU) can reduce mortality from ovarian cancer. Secondary objectives are to assess screening variables other than mortality for each of the interventions including sensitivity, specificity, and positive predictive value; to assess incidence, stage, and survival of cancer cases; and to investigate biologic and/or prognostic characterizations of tumor tissue and biochemical products as intermediate endpoints. The design is a multicenter, two-armed, randomized trial with 37,000 females and 37,000 males in each of the two arms. In the intervention arm, the PSA and CA125 tests are performed at entry, then annually for 5 years. The DRE, TVU, and chest X-ray exams are performed at entry and then annually for 3 years. Sigmoidoscopy is performed at entry and then at the 5-year point. Participants in the control arm follow their usual medical care practices. Participants will be followed for at least 13 years from randomization to ascertain all cancers of the prostate, lung, colorectum, and ovary, as well as deaths from all causes. A pilot phase was undertaken to assess the randomization, screening, and data collection procedures of the trial and to estimate design parameters such as compliance and contamination levels. This paper describes eligibility, consent, and other design features of the trial, randomization and screening procedures, and an outline of the follow-up procedures. Sample-size calculations are reported, and a data analysis plan is presented.

Colorectal Neoplasms↗

PubMedDate not supplied

[Distribution of polyps in the inside region of Vizcaya (Spain): implications for diagnostic tests and colorectal cancer screening].

INTRODUCTION: The importance of colonic polyp is increasing because colorectal cancer (CRC) screening is based on their identification. However, consensus is lacking on which technique should be used in CRC screening, whether colonoscopy or other methods such as sigmoidoscopy, which shows good sensitivity only in distal segments of the colon. We studied the characteristics and localization of polyps in our environment to verify their tendency to change localization and determine the implications of this in screening. MATERIAL AND METHODS: We reviewed the prevalence and characteristics of colonic polyps in 3604 patients who underwent colonoscopy for various causes in our service, as well as their distribution in 837 patients with a diagnosis of polyps who underwent complete colonoscopy. Localization proximal or distal to the splenic flexure and polyp size (less than or more than 1 cm) were analyzed. RESULTS: Polyps were found in 28.3% of 3604 patients (11.7% showed polyps > or = 1 cm). Of the 837 patients who underwent complete colonoscopy, proximal polyps were found in 44.9% (14.6% showed polyps > or = 1 cm), while distal polyps were found in 79.9% (30.3% showed polyps > or = 1 cm). Both proximal and distal polyps were found in 24.8%. The probability of finding both proximal and distal lesions was 31%. Proximal lesions without distal lesions were found in 20% of the patients (5.6% presented polyps > or = 1 cm), and consequently sigmoidoscopy would miss 15.6% of polyps > or = 1 cm. CONCLUSIONS: A relatively high percentage of patients with proximal polyps > or = 1 cm would remain undiagnosed if complete colonoscopy were only performed in patients with distal polyps. Because of the well-known increase in the frequency of proximal polyps and because a considerable number of these present without distal sentinel lesions, there are increasing arguments for considering colonoscopy as the basic technique for CRC screening.

Colon↗

PubMed2003

Colon cancer during pregnancy.

The medical community should become mobilized to diagnose colon cancer earlier in pregnancy to improve prognosis. The primary care physician or obstetrician should refer the pregnant patient with significant gastrointestinal complaints to the gastroenterologist for evaluation. Likewise, the gastroenterologist should be prepared to perform sigmoidoscopy, preferably without endoscopic medications, for significant lower gastrointestinal symptoms such as persistent rectal bleeding. Sigmoidoscopy is particularly sensitive in identifying colon cancer in pregnant patients because their cancers are usually distal and within reach of the sigmoidoscope.

Antineoplastic Agents↗

PubMed2002

Radiologic imaging modalities in the diagnosis and management of colorectal cancer.

Colorectal carcinoma poses a serious public health threat. Detection in its early stages in the best predictor for long-term survival, which is the impetus for population-based screening programs. We believe that full-colon imaging by either DCBE or colonoscopy is necessary for colon cancer screening because flexible sigmoidoscopy, even if perfect, only detects 50% to 60% of colon cancers, a rate far worse than even the worst rate reported for single-contrast barium enema. Screening for colon cancer with flexible sigmoidoscopy is equivalent to performing a "left" mammogram for the detection of breast cancer. The role of CT colonography is still to be determined. When confronted with a symptomatic patient, barium enema is applied in conjunction with CT to detect primary colorectal carcinoma, to differentiate it from other benign and malignant processes involving the colon, and to assess for disease extent before surgery in selected high-risk patient populations. Pelvic MRI may be useful in the preoperative assessment of patients with rectal carcinoma as a means for assisting surgical planning. CT, MRI, and barium enema are used in postoperative follow-up for detecting local recurrence and distant spread. In response to known difficulty in discriminating between normal postoperative changes and tumor recurrence and in determining the nature of certain liver lesions, FDG-PET has been approved for the detection and localization of recurrent colorectal cancer in patients with rising CEA levels and indeterminate findings on standard imaging studies. Given its current promise of offering high sensitivity, specificity, and accuracy, the indications for PET may well expand in the future, but its final role in still to be determined.

Aged↗

PubMed2002

Fecal occult blood test screening for colorectal cancer.

In summary, high-quality scientific studies indicate that the use of the FOBT for colorectal cancer screening has a number of important advantages. The test is capable of detecting most early colorectal cancers and many advanced adenomas. It has been shown in randomized, controlled trials to reduce substantially colorectal cancer mortality and incidence. The FOBT is feasible, widely available, and acceptable to most individuals. It has a low up-front cost and is highly cost-effective. Combining annual FOBT with periodic flexible sigmoidoscopy seems to be an especially effective screening option. Limitations of FOBT screening include its low sensitivity for polyps, especially smaller ones. Some of the trials report a relatively low sensitivity for detecting cancers located in the distal colon. The test has a relatively low specificity, so there are many false-positive screens; and for it to be most effective, repetitive screening is necessary. Balancing these advantages and disadvantages, the evidence-based screening guidelines have concluded that FOBT screening has a major role to play in colorectal cancer control and a program of annual FOBT plus flexible sigmoidoscopy every 5 years is a preferred option for screening the asymptomatic, average-risk population for colorectal cancer. Short of doing direct colonoscopy screening for the entire at-risk population, the FOBT currently is the best available method of identifying asymptomatic, average-risk people most likely to benefit from colonoscopy.

Colonic Polyps↗

PubMed2001

Racial and ethnic colorectal cancer patterns affect the cost-effectiveness of colorectal cancer screening in the United States.

BACKGROUND & AIMS: Colorectal cancer screening beginning at age 50 is recommended for all Americans considered at "average" risk for the development of colorectal cancer. METHODS: We used 1988-1995 California Cancer Registry data to compare the cost-effectiveness of two 35-year colorectal cancer screening interventions among Asians, blacks, Latinos, and Whites. RESULTS: Average annual age-specific colorectal cancer incidence rates were highest in blacks and lowest in Latinos. Screening beginning at age 50 was most cost-effective in blacks and least cost-effective in Latinos (measured as dollars spent per year of life saved), using annual fecal occult blood testing (FOBT) combined with flexible sigmoidoscopy every 5 years and using colonoscopy every 10 years. A 35-year screening program beginning in blacks at age 42, whites at age 44, or Asians at age 46 was more cost-effective than screening Latinos beginning at age 50. CONCLUSIONS: Colorectal cancer screening programs beginning at age 50, using either FOBT and flexible sigmoidoscopy or colonoscopy in each racial or ethnic group, are within the $40,000-$60,000 per year of life saved upper cost limit considered acceptable for preventive strategies. Screening is most cost-effective in blacks because of high age-specific colorectal cancer incidence rates.

Adult↗

PubMed2001

Right-sided shift found in metachronous colorectal adenomas.

BACKGROUND AND STUDY AIMS: Patients who have had a colorectal adenoma are likely to develop a metachronous adenoma, and therefore need to be kept under surveillance. The question is whether metachronous adenomas will be found at the same anatomical site as the preceding adenomas, thus prompting us to focus surveillance examinations on this region, using flexible sigmoidoscopy or total colonoscopy. PATIENTS AND METHODS: Between 1978 and 1996 a long-term follow up of 1091 patients was prospectively documented at the Erlangen Registry of Colorectal Polyps. The anatomical sites--distal (rectosigmoid) and proximal colon--of two subsequent generations of metachronous adenomas were analysed using logistic regression analysis. RESULTS: In 556 (51%) patients metachronous adenomas were found during follow up. In 211 (37.9%) of these patients a right-sided shift in the first generation of metachronous adenomas in comparison with initial lesions (P<0.0001) was found. Some 305 patients underwent further follow up, and 51 (27.1%) out of 188 patients with metachronous lesions demonstrated a right-sided shift in their second generation (vs. first generation) of metachronous adenomas. Proximally located first generation metachronous adenomas would be missed by flexible sigmoidoscopy in 50.8% of patients with only distal adenomas at baseline colonoscopy, and in 58.7% of patients with second-generation lesions. Multivariate analysis revealed that multiplicity (odds ratio 2.64, 95% CI 1.49-4.66) and size of initial adenomas (>5 mm) (odds ratio 3.60, 95% CI 1.96-6.66) were significantly associated with a right-sided shift in metachronous adenomas, while female gender was associated with a significantly lower tendency to manifest a right-sided shift (odds ratio of 0.64. 95% CI 0.43-0.94). CONCLUSIONS: Metachronous adenomas are found significantly more often in the right colon than would be expected assuming clustering at the same anatomical site as the preceding lesions. Total colonoscopy is thus needed for surveillance, regardless of the initial adenoma site.

Adenoma↗

PubMed1982

A prospective study of diagnostic methods in adenoma follow-up.

Three hundred and thirty patients having had previous colonoscopic polypectomy of adenomas were recalled for follow-up and submitted to all available diagnostic methods: occult blood testing, digital examination, rigid proctosigmoidoscopy, fibre-optic sigmoidoscopy, total colonoscopy and double contrast barium enema. Polyps up to 7 mm diameter were electro-coagulated during diagnostic endoscopy but larger polyps were left in situ for barium enema before polypectomy at a later date. Disparities between endoscopy and X-ray were rechecked by one or both procedures. Occult blood testing, digital examination and rigid proctosigmoidoscopy were found to be inaccurate or ineffective in diagnosis of the 37% of patients with further adenomas or carcinomas. Double contrast barium enema demonstrated 71% of larger lesions compared to the 92% shown by colonoscopy. The commonest sites of X-ray inaccuracy were in the sigmoid colon and caecum. Colonoscopy permits immediate electrocoagulation or snare polypectomy of any lesions seen, as well as being the more accurate investigation and is, therefore, the procedure of choice in post polypectomy follow-up. The mean time taken for diagnostic total colonoscopy in this series was 15.3 minutes, comparable to the time taken for barium enema. Postal questionnaire showed both procedures to be equally well tolerated by the patients. Thirty per cent of colonoscopies were, however, considered technically difficult by the endoscopist, and for these patients it is suggested that follow-up should be by the combination of fibre-sigmoidoscopy using carbon dioxide insufflation and immediate double contrast barium enema. Should this combination indicate a need for total colonoscopy, then almost all adenomas and cancers would be detected. Total examination of the colon by one or other means is essential, over half the patients with adenomas and three of the five patients with carcinoma showing no pathology in the territory of fibresigmoidoscopy or limited colonoscopy.

Adenoma↗

PubMed1994

[Abdominal complications following heart surgery].

OBJECTIVE: Intra-abdominal complications occurring after cardiopulmonary bypass operations are rare but often fatal. There are only speculative approaches concerning the pathogenesis and the risk factors of these complications. The aim of our study was therefore to determine the causative factors and to evaluate the diagnostic and therapeutic measures, because early diagnosis and immediate treatment is essential for the outcome of the patients. DESIGN: 500 consecutive patients who underwent cardiopulmonary bypass procedures over a period of 14 months were examined for intra-abdominal complications. The records of these patients were reviewed in relation to possible risk factors and the group with intra-abdominal complications was compared with a random sample of 50 patients in respect of possible risk factors. The diagnostic procedures (serum lactate concentrations, sigmoidoscopy, coloscopy) and the therapeutic interventions were also evaluated. MAIN RESULTS: 9 (1.8%) of the 500 patients developed intra-abdominal complications. The mortality rate was 44% (4 of 9). 5 patients had bowel necrosis or ischaemic colitis. Pseudo-obstruction appeared in 5 cases. One patient developed cholecystitis and one acute haemorrhagic pancreatitis. Gastroduodenal complications were not observed. There was no difference between the group with intra-abdominal complications and the random sample with regard to sex, type of operation and preoperative intra-abdominal diseases. Clinical risk factors identified were: age, occlusive vascular disease, atrial fibrillation, prolonged aortic cross-clamping times and mean bypass times, intraoperative and postoperative need for supply of epinephrine and norepinephrine, implantation of an intraaortic balloon counterpulsation pump, low cardiac output, postoperative multiple organ failure. 8 out of the 9 patients had severe intraoperative surgical complications or general complications in the postoperative course. All patients with bowel necrosis or ischaemic colitis had abnormal serum lactate concentrations. With the aid of sigmoidoscopy in one patient, only bowel necrosis or ischaemic colitis could be detected. In one patient with pseudoobstruction, an operation was probably obviated by decompression of the colon by coloscopy. 6 of the 500 patients after cardiopulmonary bypass required emergency laparotomy. Two patients with bowel necrosis were saved by early hemicolectomy. CONCLUSION: In reviewing both our results and data cited in earlier studies, intra-abdominal complications can generally be attributed to the following: Intraoperative surgical complications with the consequence of prolonged aortic cross clamping and total bypass times can cause low cardiac output and mesenteric hypoperfusion. Predominantly as a result of the low cardiac output, the use of vasopressors increases splanchnic ischaemia, in particular in patients with pre-existing occlusive vascular disease of the mesenteric arteries. Mucosal ischaemia might be aggravated by a concurrent pseudo-obstruction. On the other hand, intraoperative complications and low cardiac output can cause further complications and finally multiple organ failure. Multiple organ failure and ischaemia of the gut can initiate the vicious circle which is responsible for the high mortality from these complications. Early detection by careful physical examination and the combination of the diagnostic procedures and prompt treatment should lead to a reduction of mortality.

Abdomen↗

PubMed1992

Colorectal cancer. Identifying and screening high-risk patients.

Colorectal carcinoma is a major cause of cancer-related morbidity and mortality in the United States. High-risk patients should be appropriately identified and screened. Current recommendations from the American Cancer Society for the average-risk patient include both digital rectal examination and fecal occult blood testing annually beginning at age 40, as well as flexible sigmoidoscopy every 3 to 5 years beginning at age 50 after two normal annual examinations. If any of these tests yield positive results, complete examination of the colon with colonoscopy is indicated. The reliability, sensitivity, and cost-effectiveness of both digital examinations and stool occult blood testing have not been reported to be adequate for screening large populations. A more practical approach may be to omit stool testing and recommend screening with flexible sigmoidoscopy for average-risk patients aged 50 and older. Patients with distal adenomas should undergo colonoscopy and polypectomy as necessary, with follow-up colonoscopy determined by the number of polyps and success in removal.

Colonoscopy↗

PubMed1993

Cancer control knowledge and priorities among primary care physicians.

Primary care physicians can play a key role in prevention and early detection of cancer. To assess cancer control knowledge and priorities among primary care physicians in Missouri, we conducted a random survey of 207 physicians. Although reported knowledge of the role tobacco plays in cancer causation was high, activity in tobacco cessation counselling and referral was low. Respondents considered diet to be a relatively unimportant factor in cancer causation, whereas they viewed sun exposure, genetics/family history, and radiation exposure as large contributors to the cancer burden. Among cancer early detection tests, high activity was shown for the Pap test and breast examination. Conversely, low activity was reported for colon sigmoidoscopy. Inverse correlations were shown between age group of the physician and several cancer prevention and early detection practices. For each cancer prevention and screening practice, reported activity was higher for medical doctors than for doctors of osteopathic medicine. Possible barriers or controversies in cancer control included disagreement with the current recommendation for Pap testing, the cost of mammography, and patient fear of sigmoidoscopy. These findings suggest that primary care physicians are not achieving their full potential in cancer control and indicate areas where increased emphasis is warranted.

Attitude of Health Personnel↗

PubMed1999

Assessing the need for faculty development in women's health among internal medicine and family practice teaching faculty. The Women's Health Education Working Group (WHEWG).

Women's health education is an emerging interdisciplinary field that has recently received national attention. The American Board of Internal Medicine and the American Academy of Family Practice recently have published competencies in women's health for their residents, with increased attention to gynecological and mental health issues. Increasing women's health in the curricula of internal medicine (IM) and family practice (FP) residents will certainly require faculty development among IM and FP teaching faculty. We report a multiinstitution needs assessment among IM and FP teaching faculty for continuing medical education (CME) in multidisciplinary women's health topics. The survey (n = 100) asked whether faculty desired CME in 30 women's health topics. It also requested rates of referral to specialists for breast and menstrual problems and performance of tests commonly carried out in the care of women (e.g., endometrial biopsy, colposcopy, skin biopsy, and sigmoidoscopy) as measures of possible need for CME. Of the 69 respondents, 37% were IM physicians and 63% were FP physicians. Among the 30 women's health topics listed, breast cancer treatment alternatives, infertility for primary care providers, cervical dysplasia, medical treatment in pregnancy, vulvar disease, indications for pelvic ultrasound/endometrial biopsy, and menstrual disorders were of highest interest. The ranking of desirability of topics by IM and FP faculty correlated by .54 (Spearman rank, df = 28, p < 0.01). Analysis of variance revealed a significantly higher interest overall by IM than FP physicians, 58% vs. 42% (F = 4.1, df = 1, 50, p < 0.05). None of the IM teaching faculty performed endometrial biopsy or colposcopy compared with 57% of FP physicians, and only 12.5% of internists performed skin biopsy and sigmoidoscopy compared with 70% of FP physicians (F = 33, df = 1, 38, p < 0.001). We conclude that faculty development in women's health would benefit resident training in IM and FP, and topics of interest are identifiable. The correlation in interests between the IM and FP teaching faculty might make joint programs successful, although gynecological skills and knowledge clearly are needed more by IM teaching faculty. Obstetrics and gynecology (OB/GYN) faculty could be instrumental in improving women's health education among their IM and FP colleagues.

Education, Medical, Continuing↗

PubMed1998

Colorectal cancer in women: an underappreciated but preventable risk.

Colorectal cancer is the third most common non-skin malignancy in women, after breast and lung cancer. Although approximately 40% of the 65,000 women diagnosed each year eventually die of the disease, colon cancer is highly curable when diagnosed at an early stage. Moreover, because the majority of colon cancers arise in previously benign colonic polyps, there is a substantial period, up to several years, in which removal of polyps can reduce the risk of colon cancer. Recently, the United States Preventive Task Force recommended universal screening for colon cancer after age 50. Strong evidence from randomized controlled trials and case-control studies supports use of annual testing for occult blood in stool and flexible sigmoidoscopy every 5-7 years. Although the risk of colon cancer is similar in men and women, women frequently have the perception that colorectal cancer is a man's disease. Partially in consequence, women are less likely than men to undergo screening sigmoidoscopy. Further barriers include primary care providers' lack of awareness of updated guidelines and patients' lack of compliance with multiple screening tests and their fear of discomfort. Because the risk of colorectal cancer can be reduced by up to 75% in those who undergo screening and subsequent surveillance to remove further polyps, it is crucial that women be targeted to undergo screening tests for colorectal cancer.

Age Distribution↗

PubMed1998

Does age influence screening for colorectal cancer?

OBJECTIVE: To evaluate whether patients' age influenced colorectal cancer screening by internal medicine resident physicians in an ambulatory care clinic. METHODS: A retrospective chart review of 200 patients aged >50 years to assess the performance of rectal examinations, faecal occult blood testing and flexible sigmoidoscopy. RESULTS: Physicians performed rectal examinations in 21 patients 10.5%, faecal occult blood testing in 85 (42.5%) and flexible sigmoidoscopies in 95 (47.5%). Significantly more rectal examinations were performed in patients aged 50-60 years than in patients aged 61-70 years (P < 0.005) or > or = 71 years (P < 0.00002). There was significantly more faecal occult blood testing in patients aged 50-60 years than in those aged > or = 71 years (P < 0.02). In women, there were more rectal examinations in those aged 50-60 years than in those aged 61-70 years (P < 0.05) or > or = 71 years (P < 0.008). Men aged 61-70 years had more rectal examinations than men aged > or = 71 years (P < 0.04). CONCLUSIONS: Colorectal cancer screening is performed less often in older patients attending a hospital for health maintenance evaluation. Chronological age alone should not determine whether physicians screen for colorectal cancer.

Age Factors↗