CLINICAL-EXPERIENCE WITH FLEXIBLE SIGMOIDOSCOPY IN ASYMPTOMATIC AND SYMPTOMATIC PATIENTS

  • 1 January 1980
    • journal article
    • research article
    • Vol. 53  (5) , 345-352
Abstract
The diagnostic yield of flexible sigmoidoscopy when performed as a routine procedure in asymptomatic patients over the age of 40, was evaluated. The preliminary results of this ongoing program are presented together with the diagnostic yield in 408 patients with symptoms and signs suggestive of colorectal disease who were of similar age (56.6 vs. 56.5 yr) and sex distribution (79% male) to the asymptomatic population and who underwent flexible sigmoidoscopy as an indicated part of their evaluation. Adenomatous and hyperplastic polyps were identified in 16 patients, 13.1% in the asymptomatic group, a similar percentage to the symptomatic population 15.4%. Adenomatous polyps were diagnosed in 7.4% of the asymptomatic subjects and 9.1% of the symptomatic group. Colonic cancer was diagnosed in 0.8% of asymptomatic patients vs. 3.2% of the symptomatic group (P < 0.05). Seventy-seven percent of the neoplastic polyps detected in the asymptomatic patients and 60% in the symptomatic group were beyond 20 cm from the anus. Diverticulosis was diagnosed in a similar percentage of patients, 13.1% in the asymptomatic and 10.0% in the symptomatic group. No complications were encountered and the procedure was well tolerated without analgesia. In an asymptomatic population over the age of 40, flexible sigmoidoscopy as a routine examination, evidently results in a diagnostic yield not possible with rigid proctosigmoidoscopy and which approaches that observed in a symptomatic population of similar age. For the internist trained in this procedure, flexible sigmoidoscopy evidently has a future role in the detection of colorectal lesions and as an interval screening examination for premalignant lesions and colorectal cancer in asymptomatic and symptomatic patients.