title: Four-year evaluation of a direct-access fibreoptic sigmoidoscopy service.
abstract: Over a 4-year period, a direct-access fibreoptic sigmoidoscopy service was evaluated prospectively. In all, 756 patients were referred (median age 58 years, range 18-91 years). The principal indications were rectal bleeding (45%) or change of bowel habit (28%); both features were present in 13%. Abnormalities were present in 68% of examinations. Major disease was identified in 22% (carcinoma 7.0%, adenoma 6.3%, inflammatory bowel disease 8.3%) and minor disease in 53% (haemorrhoids 36.8%, severe diverticular disease 10.9%, non-adenomatous polyp 3.4%, perianal disease 1.4%). In patients under 40 years of age, major disease was rare (one carcinoma, three adenomas). Of the patients, 21% underwent barium enema for incomplete examination or suspected additional disease. No additional major disease was identified, but one carcinoma found in a patient with stricture. These data show that a direct-access fibreoptic sigmoidoscopy service produces a high diagnostic yield and may be of value to both patients and general practitioners in expediting a clinical colorectal service.
authors.affiliation: Department of Surgery, George Eliot Hospital, Nuneaton, Warwickshire.
authors.forename: M N
authors.initials: MN
authors.lastname: Vipond
authors.forename: V
authors.initials: V
authors.lastname: Moshakis
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000175:diagnosis*; D003110:Colonic Neoplasms / Q000175:diagnosis; D004739:England; D005069:Evaluation Studies as Topic; D005336:Fiber Optic Technology / Q000458:organization & administration*; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012002:Rectal Diseases / Q000175:diagnosis*; D012004:Rectal Neoplasms / Q000175:diagnosis; D012812:Sigmoidoscopy