title: A prospective evaluation of the feasibility of primary screening with unsedated colonoscopy.
abstract: BACKGROUND
  Colonoscopy is the most effective screening tool for colorectal cancer. In Taiwan, colonoscopy is used much less than sigmoidoscopy for screening because sedation significantly increases the cost and is not readily available, and unsedated colonoscopy is considered to be poorly tolerated. However, unsedated colonoscopy has been shown to be well accepted and may improve the cost-effectiveness and access to colonoscopic screening.
  
  
  OBJECTIVE
  To compare the feasibility of unsedated colonoscopy and sigmoidoscopy for primary screening and to analyze factors associated with acceptance of the procedures and need for sedation.
  
  
  METHODS
  Single center, prospective.
  
  
  METHODS
  National Taiwan University Medical Center. POPULATION AND INTERVENTIONS: A consecutive series of 261 subjects without history of colonoscopy or sigmoidoscopy who underwent unsedated colonoscopy (n = 176) or sigmoidoscopy (n = 85) for primary screening.
  
  
  METHODS
  Pain scores, acceptance, and need for sedation.
  
  
  RESULTS
  No significant differences in pain, acceptance, and need for sedation were found between the colonoscopy and sigmoidoscopy groups. Only 9.6% in the colonoscopy group and 10.1% in the sigmoidoscopy group considered sedation necessary. Multivariate analyses revealed that the examinee's sex and the endoscopist, but not the type of endoscopic examination, were associated with the severity of pain and need for sedation.
  
  
  CONCLUSIONS
  Nonrandomized study design.
  
  
  CONCLUSIONS
  Unsedated colonoscopy for primary screening is well accepted in nine tenths of examinees who accept this option and is similar to sigmoidoscopy in pain, acceptance, and need for sedation. Primary screening with unsedated colonoscopy is feasible, as with sigmoidoscopy.
authors: Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, National Taiwan University College of Medicine, Taipei, Taiwan.
authors: Wei-Chih
authors: WC
authors: Liao
authors: Han-Mo
authors: HM
authors: Chiu
authors: Chien-Chuan
authors: CC
authors: Chen
authors: Yi-Chia
authors: YC
authors: Lee
authors: Ming-Shiang
authors: MS
authors: Wu
authors: Jaw-Town
authors: JT
authors: Lin
authors: Ariel Sing-Huei
authors: AS
authors: Wu
authors: Hsiu-Po
authors: HP
authors: Wang
mesh_terms: D000328:Adult; D003113:Colonoscopy / Q000191:economics*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D016292:Procedural Sedation; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011446:Prospective Studies; D012812:Sigmoidoscopy / Q000191:economics*; D013624:Taiwan