Flexible sigmoidoscopy and the despecialization of gastrointestinal endoscopy. An environmental impact report.
BACKGROUND
Gastrointestinal endoscopy is a diagnostic and therapeutic tool for the prevention of premature death from cancer. Flexible equipment innovations during the 1970s increased the power of this technique dramatically. For family physicians and general internists, dissemination of these techniques started around 1979 and continued during the 1980s.


METHODS
In this report, data describing the gradual reformation of primary-care cancer screening are discussed.


RESULTS
For example, one longitudinal study revealed a sustained improvement in physician compliance with American Cancer Society guidelines associated with the advent of flexible sigmoidoscopy and short colonoscopy skills. For symptomatic patients, compliance increased from 2% to 79% over 5 years.


CONCLUSIONS
Flexible sigmoidoscopy is now well accepted. Endoscopic biopsy, full colonoscopy, and polypectomy skills are now available to many primary-care physicians. This represents a technical advance, and it is a small part of a larger medical-care revolution in which technology is decentralized. This holds great promise for the eradication of premature death from colorectal cancer.
Rodney
W M
WM
Department of Family Medicine, University of Tennessee, Memphis 38104.
D003113:Colonoscopy / Q000379:methods / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005194:Family Practice; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D012812:Sigmoidoscopy / Q000379:methods* / Q000706:statistics & numerical data