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  • Title: Screening flexible sigmoidoscopy by primary care physicians. Effectiveness and costs in patients negative for fecal occult blood.
    Author: Rumans MC, Benner KG, Keeffe EB, Custis JM, Lockwood DR, Craner GE.
    Journal: West J Med; 1986 Jun; 144(6):756-8. PubMed ID: 3088841.
    Abstract:
    A total of 252 consecutive screening flexible sigmoidoscopies were done by two community-based general internists on asymptomatic patients with stool negative for occult blood. Neoplastic lesions were found in 26 patients (10.3%), including 27 adenomatous polyps, 2 with carcinoma-in-situ and 1 carcinoid tumor. No complications resulted from flexible sigmoidoscopy. Nineteen patients with positive screening sigmoidoscopy underwent colonoscopy, and additional adenomatous polyps were found in six patients (31.6%), but no additional malignancy. Total cost for screening flexible sigmoidoscopy and additional studies was $30,359 ($1,168 per patient with a polyp or malignancy and $10,119 per patient with a malignant lesion). Screening flexible sigmoidoscopy can be safely done by community-based general internists in asymptomatic patients with a diagnostic yield comparable with that reported by subspecialists; total costs are acceptable.
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