Patient response to sigmoidoscopy recommendations via mailed reminders

The survey reported here was undertaken to determine how many people would schedule a sigmoidoscopy after being informed by letter about the American Cancer Society's (ACS's) recommendations for colorectal screening. Letters (1,024) were sent to all patients aged over 50 years who were registered in a community-based family practice residency program. Four hundred twenty-nine responded. Of those who responded, 16.8 percent indicated interest in a rectal examination, 21 percent were interested in testing their stool for occult blood, 13.1 percent desired a sigmoidoscopy, and 11.7 percent indicated that they had previously had a sigmoidoscopy. The following reasons were given by responders who were not interested in sigmoidoscopy: 42 percent felt good and did not perceive a need, 31 percent were concerned about cost, 12.1 percent were concerned about discomfort, and 8.6 percent stated fear as a reason for their response. Of the 56 patients who indicated interest in a sigmoidoscopy, 10 patients had the procedure done (flexible 60-cm sigmoidoscope). Although the ACS recommends that everyone aged over 50 years have a sigmoidoscopy, few patients in this population who responded have had the procedure done. Encouragement and education for patients in colorectal screening, however, is worthwhile. Two colorectal carcinomas were detected as a result of this survey.