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Screening flexible sigmoidoscopy in a low-risk, highly screened population
M S Sakamoto1, J H Hara, J M Schlumpberger
1Department of Family Practice, Kaiser Permanente Medical Center, Los Angeles, CA 90027.
The Journal of Family Practice
|March 1, 1994
Summary
Rescreening with flexible sigmoidoscopy yielded few polyps in patients with prior negative exams. This suggests current screening intervals may be too frequent for low-risk individuals.
Area of Science:
- Gastroenterology
- Preventive Medicine
- Oncology
Background:
- The effectiveness of repeat flexible sigmoidoscopy screening in individuals with a prior negative examination is not well-established.
- Previous studies have not specifically evaluated the yield of rescreening asymptomatic patients.
Purpose of the Study:
- To assess the efficacy of screening flexible sigmoidoscopy in patients who have previously undergone a negative screening sigmoidoscopy.
- To determine the polyp detection rate in patients undergoing baseline versus repeat flexible sigmoidoscopy.
Main Methods:
- A retrospective chart review of 866 asymptomatic patients undergoing flexible sigmoidoscopy was conducted.
- Patients with a history of polyps were excluded. Data on lesion findings and prior screening history were recorded.
Main Results:
- Only 1.4% of all patients had polyps detected.
- Patients undergoing rescreening had a significantly lower polyp detection rate (0.4%) compared to those undergoing baseline screening (2.4%).
Conclusions:
- Screening flexible sigmoidoscopy has a low positivity yield, particularly in previously screened patients.
- The findings suggest that current recommended screening intervals for asymptomatic, low-risk individuals may be excessive and could potentially be extended.