Flexible sigmoidoscopy does not significantly increase polyp and cancer detection yield when used to supplement CT colonography.
OBJECTIVE
Flexible sigmoidoscopy (FS) increases polyp and carcinoma detection in addition to double contrast barium enema (DCBE). However, CT colonography (CTC) is now the preferred technique. Our aim was to explore whether FS increases polyp and carcinoma detection rates when used in addition to CTC.


METHODS
Patients who underwent FS and CTC between 2007 and 2009 were included and data were collected from patient records. Yields of polyp, adenoma and carcinoma detection were calculated for FS and CTC.


RESULTS
In a cohort of 294 patients, CTC detected 36 patients with carcinomas while FS detected 28. One rectal cancer not seen on CTC was diagnosed by FS. Polyps were seen by CTC in 66 and FS in 45 patients. In 5 patients FS found polyps that were not detected by CTC; 3 of which were small adenomas. FS detected extra adenomas or carcinomas in 1.36% (4/294). Adding FS to CTC neither increased the cancer nor the polyp detection yield significantly.


CONCLUSIONS
This first study investigating the use of FS in addition to CTC detected little additional pathology. The routine use of FS as a supplement to CTC for adenoma and carcinoma detection is of questionable utility.
Department of Gastroenterology, University Hospitals of South Manchester NHS Foundation Trust, Manchester, UK. christian.Selinger @ web.de
C P
CP
Selinger
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Mullender
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Choudhury
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PE
Jones
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Sukumar
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Ramesh
D000236:Adenoma / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D002277:Carcinoma / Q000175:diagnosis; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003111:Colonic Polyps / Q000175:diagnosis; D023881:Colonography, Computed Tomographic / Q000295:instrumentation*; D004733:Enema; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012812:Sigmoidoscopy / Q000295:instrumentation*
D001466:Barium Sulfate