Complications of screening flexible sigmoidoscopy

Area of Science:

• Gastroenterology
• Preventive Medicine
• Clinical Outcomes Research

Background:

• Flexible sigmoidoscopy (FS) is a recommended screening tool for colorectal cancer (CRC).
• Limited data exist on adverse event risks associated with FS in routine clinical practice.
• Understanding these risks is crucial for informed screening recommendations.

Purpose of the Study:

• To determine the incidence of gastrointestinal complications following screening FS.
• To assess the risk of acute myocardial infarction (MI) after screening FS.
• To evaluate the safety profile of FS in a large, general population cohort.

Main Methods:

• A cohort of 107,704 average-risk individuals undergoing screening FS was analyzed.
• Data were collected from the Kaiser Permanente Medical Care Program between 1994 and 1996.
• Hospitalization for gastrointestinal complications or MI within 4 weeks of FS served as the primary outcome measure.

Main Results:

• The overall incidence of gastrointestinal complications requiring hospitalization was low (24/109,534 FS).
• Serious complications, including perforations and bleeding, were infrequent (7/109,534 FS).
• Complications were more common in men, and the incidence of MI post-FS was comparable to baseline rates.

Conclusions:

• Screening flexible sigmoidoscopy demonstrates a modest risk of serious adverse events in general clinical practice.
• The observed incidence of myocardial infarction after FS does not exceed expected rates for the age group.
• These findings support the safety of FS as a colorectal cancer screening modality.