The frequency of digital and endoscopic examination of the rectum before radiological barium enema

Doctor's delay in patients with rectal carcinoma is common with a frequency between 30% and 60%. The reason for delay has been supposed to be the neglectance to perform digital examination and rigid proctosigmoidoscopy in patients with symptoms of anorectal disease. Especially general practitioners have been blamed for a high percentage of this kind of doctor's delay. In this study 300 consecutive patients referred for radiological examination of the large bowel have been questioned if digital examination and rigid proctosigmoidoscopy have been performed by their referral doctor. The results show that in 19% of the cases neither digital nor proctosigmoidoscopic examination had been performed. Rigid proctosigmoidoscopy had been omitted in 44%. No statistical difference was observed in the frequency of digital examination between general practitioners (79%) and hospital doctors (84%). The low figures, both for digital examination and rigid proctosigmoidoscopy are probably causing many patients a delay in the diagnosis of a rectal carcinoma. Thus, a more intense evaluation in this area should be applied in the medical faculties and also at post graduate courses.