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Robert E. Schoen, M.D., M.P.H.

Joel Weissfeld, M.D., Dr.P.H.

University Of Pittsburgh Researchers Find Most Patients Satisfied With Flexible Sigmoidoscopy Screening

PITTSBURGH, June 25, 2000 — The majority of patients who undergo screening flexible sigmoidoscopy for colon cancer detection and prevention are satisfied and find the procedure more comfortable than expected, according to a study conducted by researchers at the University of Pittsburgh , and published in the June 26 issue of Archives of Internal Medicine.

"Screening flexible sigmoidoscopy is not used frequently enough as a cancer prevention procedure," said Robert E. Schoen, M.D., M.P.H., principal investigator of the study, director of Colorectal and GI Cancer Prevention and Control Research at the University of Pittsburgh Cancer Institute (UPCI) and assistant professor of medicine and epidemiology. "Physicians often cite patient discomfort as a reason for not requesting sigmoidoscopy, but patient experiences and attitudes toward the procedure have not been well studied."

The team evaluated 1,221 patients; 666 men, 555 women. Of those, 93 percent agreed that they would be willing to undergo another examination, and 75 percent said they would recommend the procedure to friends. Regarding pain and discomfort, 76 percent said that the examination did not cause a lot of pain, and nearly 69 percent said it was more comfortable than they expected.

"These results clearly show that physicians should not project discomfort onto patients as a reason for not requesting screening sigmoidoscopy," Dr. Schoen said. "In fact, flexible sigmoidoscopy has an enormous potential to detect colon cancer and its precursors at early stages, when they are curable."

There are about 138,000 new cases of colorectal cancer diagnosed every year. Nearly 55,000 people in the United States died from this disease in 1999. Screening for colorectal cancer is effective, as cancer develops slowly over a year from a polyp, or small growth, to a malignant stage. A flexible sigmoidoscopy, a thin, flexible tube with a light on the end, is one of the best tools for diagnosing colorectal cancer. During the procedure, the physician looks at the inside lining of the lower large intestine to check for signs of colorectal cancer or for polyps. The entire procedure takes about 10-15 minutes.

Although screening flexible sigmoidoscopy is one of the most promising techniques available for early detection of colorectal cancer, the procedure is performed in a minority of eligible patients. Normally, arrangements for screening sigmoidoscopy are made through primary care physicians (PCPs). Surveys show that although the majority of PCPs support screening, they often cite pain and discomfort as negatively influencing their decision to recommend it to their patients.

"Physician attitude can have a significant impact on patient adherence with recommendations to undergo flexible sigmoidoscopy," said Joel Weissfeld, M.D., Dr.P.H., co-investigator on the study and associate professor of epidemiology. "Previous studies have shown that PCPs often are the major determinant of whether patients receive preventive care."

"The results of this study should persuade physicians and patients to give sigmoidoscopy an opportunity to prevent colorectal cancer," Dr. Schoen said.

As the only National Cancer Institute-designated comprehensive cancer center in western Pennsylvania, UPCI is a recognized leader in providing innovative cancer prevention, detection, diagnosis and treatment; biomedical research; compassionate patient care and support; and community outreach services. UPCI investigators are world-renowned for their work in clinical and basic research on cancer.

For additional information on UPCI, please access or call UPCI’s Cancer Information and Referral Service at 1-800-237-4PCI (4724).

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