[Sigmoidoscopy as primary examination in patients with bowel symptoms]

Flexible sigmoidoscopy is recommended in the literature and is now officially recommended as the primary diagnostic method in patients with symptoms consistent with colorectal cancer. Sigmoidoscopy can detect two-thirds of all colorectal cancers.

We carried out a retrospective analysis of prospective data on symptoms and findings at FS in 682 patients, above the age of 40 years, referred to a private specialist for rectal bleeding, change in bowel habits, or unspecific abdominal symptoms. The chi 2-test and logistic multivariate regression analysis were used to estimate the predictive value of symptoms for neoplasia.

Carcinoma was found in 31 (5%) and adenoma in 76 (11%), i.e., neoplasia in 16%. Logistic multivariate regression showed that bleeding in or on the faeces (p < 0.0001, OR 10.6 and 11.6), mucous discharge (p = 0.02, OR 3.0), and change in bowel habits (p = 0.02, OR 3.0) were independent risk factors of cancer, and bleeding on the faeces (p = 0.0002, OR 3.2) or in the faeces (p = 0.02, OR 2.7) were independent risk factors of adenoma.

On the basis of the literature and the present results, we conclude that sigmoidoscopy is a suitable primary diagnostic method for the detection of neoplasia in the rectum and left colon in patients with bowel symptoms. Bleeding, mucous discharge, and change in bowel habits are independent risk factors for carcinoma and bleeding for adenoma.