While the study does not pinpoint reasons for the climb in inadequate exams, the study's author speculates that several factors that accumulate with age may be to blame, including medical conditions that can complicate the procedure.
Flexible sigmoidoscopy, one of the most common screening tools for colorectal cancer, is a fairly simple procedure that is commonly performed in a doctor's examination room. A sigmoidoscope -- a 60 centimeter-long flexible tube about the thickness of a finger -- is threaded into the patient's rectum and lower third of the colon. A tiny video camera in the sigmoidoscope allows the doctor to examine the wall of the colon for polyps, cancers or other abnormalities. In practice, the sensitivity of this procedure as a screening tool depends on how much of the colon can be viewed. A reach of 50 to 60 centimeters into the colon from the anus is considered adequate. Yet, until now, the frequency with which sigmoidoscopies attain adequate reach during routine screening has been unknown. Nor has data been available to compare performance of sigmoidoscopies between men and women or people in different age groups.
To determine the adequacy of the procedure among various age groups, Louise Walter, MD, a staff physician in geriatrics at SFVAMC and assistant professor of medicine at University of California, San Francisco, reviewed records of
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Contact: Liese Greensfelder
lgreensfelder@pubaff.ucsf.edu
415-476-8429
University of California - San Francisco
26-Jan-2004