Adeyinka Laiyemo

NCI, DCP, BRG

PLCO (Learn more about this study)

2007-0059

Dec 21, 2007

Predictors of technically inadequate flexible sigmoidoscopy screening in community-based practice settings.

Endoscopic screening modalities are fast becoming the mainstay for colorectal cancer (CRC) screening practices in the US with progressive increase in the number of colonoscopy being performed for CRC screening. l Although, colonoscopic examinations can potentially detect precursor lesions throughout the colon, on going trials of efficacy of endoscopic CRC screenings are utilizing flexible sigmoidoscopy (FSG), a similar but shorter technique that evaluates only the distal colon. The outcomes of these trials will eventually be extrapolated for the CRC screening efficacy of colonoscopy as well. The major advantages of FSG are: l No sedation required l Can be performed by a variety of healthcare providers l May be more accessible, and can be adopted on a large scale. However, inadequate FSG: l A strong predictor of refusing repeat FSG l May contribute to disparities in CRC. There is a limited data on racial/SES differences in the adequacy of screening endoscopy Hence, inadequate endoscopy may compromise the benefits of screening and waste valuable limited resources. Therefore, identifying factors that predict inadequate FSG may potentially assist in preparation and patient selection for CRC screening modalities. l PLCO definition of inadequate FSG: l < 50 cm depth of insertion l Visual inspection limited to < 90% of the mucosal surface due to inadequate bowel preparation with no detection of a polyp or mass