Flexible sigmoidoscopy is a commonly used method for colorectal cancer screening.
Women are more likely than men to have a flexible sigmoidoscopy with a limited depth of insertion.
In this study, physicians from the United States assessed satisfaction in women undergoing screening flexible sigmoidoscopy.
The team compared an upper endoscope (group E, diameter 9.8 mm) with a standard sigmoidoscope (group S, diameter 13.3 mm).
They measured pain and discomfort and overall satisfaction using a validated survey instrument. They also assessed depth of insertion of the instrument, frequency of polyp detection, and complication rate.
A total of 160 asymptomatic women underwent screening flexible sigmoidoscopy over a 4-month period. All procedures were performed by 2 experienced physician assistants.
The physicians determined that the 2 groups were of similar age and had a similar rate of previous abdominal surgery or hysterectomy.
|Pain and discomfort were less in the upper endoscope group.|
|American Journal of Gastroenterology|
The team found that depth of insertion of the scope was 54.5 cm for group E and 51.6 cm for group S.
Polyps were found in 18% of patients in group E and 10% in group S. This difference was not statistically significant.
The team established that overall satisfaction was similar in both groups, but pain and discomfort were less in group E.
There was no difference in the endoscopists’ assessment of procedure difficult and complication rates.
The team found that the total duration for the procedure was 7.2 minutes in group E and 5.7 minutes in group S.
Dr Francis Farraye and colleagues concluded, “Screening flexible sigmoidoscopy in women using an upper endoscope is a feasible approach to colorectal cancer screening”.
“Patients screened with an upper endoscope reported less pain and discomfort compared to standard sigmoidoscope while overall satisfaction did not differ”.
“The trend toward increased polyp detection in patients undergoing flexible sigmoidoscopy with an upper endoscope may be related to a more thorough examination due to less patient discomfort and/or an increased depth of insertion of the upper endoscope”.
“Thinner, more flexible endoscopes should be considered when performing screening flexible sigmoidoscopy in women”.