Flexible sigmoidoscopy (FS) is recommended for mass screening for colorectal cancer (CRC).
However, little is known about the risk of adverse events when FS is used in general clinical practice.
|Complications were significantly more common in men than in women.|
In this study, researchers from the United States sought to determine the incidence of gastrointestinal complications and acute myocardial infarction (MI) after screening FS.
The research team assessed 107,704 subjects of average risk for CRC, who underwent screening FS, between 1994 and 1996, as part of the Colorectal Cancer Prevention (CoCaP) program. The mean age of subjects was 61 years, and 49% were female.
The team's main outcome measure was hospitalization for gastrointestinal complications, or acute MI within 4 weeks of FS.
Non-gastroenterologist physicians, nurses, or physician assistants performed 72% of FS.
Overall, only 24 subjects were hospitalized for a gastrointestinal complication. Of these, 7 were serious (2 perforations, 2 episodes of diverticulitis requiring surgery, 2 cases of bleeding requiring transfusion, and 1 episode of unexplained colitis).
However, using multivariate analysis, the team found that complications were significantly more common in men than in women (odds ratio, 3.34).
In addition, MI occurred in 33 persons within 4 weeks of FS, but the incidence for this period was similar to that in the subsequent 48 weeks (rate ratio, 0.8).
Dr Theodore Levin's team concluded, "The risk of serious complications after screening FS in this setting appears to be modest".
"Although MI occurs after FS, the risk during the 4 weeks after the procedure appears to be similar to expectations for persons of screening age".