Incomplete screening flexible sigmoidoscopy associated with female sex, age, and increased risk of colorectal cancer

Doria-Rose, V. P.; Newcomb, P. A.; Levin, I. R.
September 2005
Gut;Sep2005, Vol. 54 Issue 9, p1273
Academic Journal
Background: Several previous studies have found that females and older individuals are at greater risk of having incomplete flexible sigmoidoscopy. However, no prior study has reported the subsequent risk of colorectal cancer (CRC) following incomplete sigmoidoscopy. Methods: Using data from 55 791 individuals screened as part of the Colon Cancer Prevention (CoCaP) programme of Kaiser Permanente of Northern California, we evaluated the likelihood of having an inadequate (<40 cm) examination by age and sex, and estimated the risk of distal CRC according to depth of sigmoidoscope insertion at the baseline screening examination. Multivariate estimation of risks was performed using Poisson regression. Results: Older individuals were at a much greater risk of having an inadequate examination (relative risk (RR) for age 80+ years compared with 50-59 years 2.6 (95% confidence interval (Cl) 2.3-3.0)), as were females (RR 2.3 (95% Cl 2.2-2.5)); these associations were attenuated but remained strong if Poisson models were further adjusted for examination limitations (pain, stool, and angulation). There was an approximate threefold increase in the risk of distal CRC if the baseline sigmoidoscopy did not reach a depth of at least 40 cm; a smaller increase in risk was observed for examinations that reached 40-59 cm. Conclusions: Older individuals and women are at an increased risk of having inadequate sigmoidoscopy. Because inadequate sigmoidoscopy results in an increased risk of subsequent CRC, physicians should consider steps to maximise the depth of insertion of the sigmoidoscope or, failing this, should consider an alternative screening test.


Related Articles

  • TEST MAY REDUCE DEATH RATE FROM COLORECTAL CANCER.  // Cleveland Clinic Men's Health Advisor;Aug2012, Vol. 14 Issue 8, p2 

    The article reports on the study published in the "New England Journal of Medicine" on May 21, 2012, which revealed that screening of colorectal cancer through flexible sigmoidoscopy may reduce deaths and may prevent new cases.

  • Digestive Disease Week: New England Journal of Medicine.  // Biomedical Market Newsletter;5/25/2012, Vol. 21, p1 

    The article offers information on a study related with efficacy of flexible sigmoidoscopy in reduction of colorectal cancer rates.

  • Testing for faecal calprotectin (PhiCal) in the Norwegian Colorectal Cancer Prevention trial on flexible sigmoidoscopy screening... Hoff, G.; Grolmol, T.; Thiis-Evensen, E.; Bretthauer, M.; Gondal, G.; Vatn, M. H. // Gut;Sep2004, Vol. 53 Issue 9, p1329 

    Background: Screening for colorectal cancer (CRC) using guaiac based fecal occult blood tests (FOBT) has an estimated programme sensitivity of >60% but <30% for strictly asymptomatic CRC in a single screening round. In search for improved non-invasive tests for screening, we compared a test for...

  • Colorectal Cancer Screening and Prevention in Women. Chacko, Lyssa; Macaron, Carole; Burke, Carol // Digestive Diseases & Sciences;Mar2015, Vol. 60 Issue 3, p698 

    Colorectal cancer (CRC) is one of the leading cancers and cause of cancer deaths in American women and men. Females and males share a similar lifetime cumulative risk of CRC however, substantial differences in risk factors, tumor biology, and effectiveness of cancer prevention services have been...

  • Flexible sigmoidoscopy: Screening for colorectal cancer. JOHNSON, BRETT ANDREW // American Family Physician;1/15/1999, Vol. 59 Issue 2, p313 

    Discusses the clinical significance of flexible sigmoidoscopy used in the diagnosis of colorectal cancer. Diagnostic preparations; Common complications of the procedure; Techniques in colon visualization.

  • Colorectal Cancer and the Effect of Flexible Sigmoidoscopy Screening. Swartz, Andrew W. // JAMA: Journal of the American Medical Association;12/10/2014, Vol. 312 Issue 22, p2411 

    A letter to the editor is presented in response to the article "Effect of Flexible Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality: A Randomized Clinical Trial," by Ø Holme et al that was published in a 2014 issue.

  • Colorectal Cancer and the Effect of Flexible Sigmoidoscopy Screening. Holme, Øyvind; Loberg, Magnus; Kalager, Mette // JAMA: Journal of the American Medical Association;12/10/2014, Vol. 312 Issue 22, p2411 

    A reply by Øyvind Holme et al to a letter to the editor about their article "Effect of Flexible Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality: A Randomized Clinical Trial,"that was published in a 2014 issue is presented.

  • Routine sigmoidoscopy may miss over half of colon cancers. E.B. // Medical Update;Nov96, Vol. 20 Issue 5, p3 

    Reveals the ineffectiveness of flexible sigmoidoscopy diagnosing colon cancer. Missing of over half of cases; Shift in distribution of cancer in the colon; Requirement of more thorough examination of colon.

  • Sigmoidoscopy Screening Probably Works, but How Well Is Still Unknown. Mandel, Jack S. // JNCI: Journal of the National Cancer Institute;4/16/2003, Vol. 95 Issue 8, p571 

    Editorial. Explores the benefits of sigmoidoscopy in colorectal cancer screening. Randomized controlled trial; Risks associated with sigmoidoscopy; Cost-effectiveness of the screening.

  • Sigmoidoscopy screening for colorectal cancer. Imperiale, Thomas F. // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;6/6/2009, Vol. 338 Issue 7707, p1339 

    The author explores the effectiveness of sigmoidoscopy screening in reducing mortality from colorectal cancer. He presents the findings of the Norwegian Colorectal Cancer Prevention (NORCCAP) trial, which support the assumption that such screening reduces mortality. He explains the reason for...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics