Reach of sigmoidoscopies inadequate in many o...( men] the study shows that a doctor migh...),Health

An additional factor that must be taken under consideration in making a recommendation, Walter says, is the fact that older age and female sex are both associated with an increased likelihood that colon polyps and cancers will occur higher up in the colon. Cancer registries report that more than 50 percent of all colorectal cancers in women older than 70 are located beyond the sigmoid colon.

"I see the results of this study as further evidence that argues against the use of sigmoidoscopies to screen older women," Walter says. "But even an inadequate exam will provide some benefit. It's certainly better than no screening at all."

The records that Walter examined did not identify reasons for the failure of sigmoidoscopies to attain adequate reach. But she cites two factors that may contribute to the differences she found between the sexes: the literature shows that women have more pain than men with sigmoidoscopies, which could prevent completion of the procedure, and women have a more pronounced curve in the sigmoid colon, which can obstruct the sigmoidoscope. One reason she did find for declining success rates of sigmoidoscopies with advancing age was that older people were less successful in attaining adequate bowel preparation, the tedious process of cleansing the bowels prior to the procedure. But there must be additional contributing factors, Walter says, because bowel preparation accounted for only a portion of the unsuccessful procedures.

The study is based on records from all 71 non-VA clinics and hospitals that participate in the Clinical Outcomes Research Initiative, a nationwide effort, supported by NIH and AstraZeneca Pharmaceuticals LP, to evaluate the outcomes of endoscopic procedures that are performed in clinical settings. Walter examined all 15,406 records of si
'"/>

Contact: Liese Greensfelder
lgreensfelder@pubaff.ucsf.edu
415-476-8429
University of California - San Francisco
26-Jan-2004