Flexible Sigmoidoscopy Does Not Significantly Increase Polyp and Cancer Detection Yield when Used to Supplement CT ColonographySelinger C.P. · Mullender J. · Choudhury S. · Jones P.E. · Sukumar S. · Ramesh J.
Departments of aGastroenterology and bRadiology, University Hospitals of South Manchester NHS Foundation Trust, Manchester, UK
Background and Aims: 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 Trust
Southmoor Road, Wythenshawe, Manchester M23 9LT (UK)
Received: June 17, 2011
Accepted: October 25, 2011
Published online: December 29, 2011
Number of Print Pages : 6
Number of Figures : 4, Number of Tables : 3, Number of References : 26
Digestion (International Journal of Gastroenterology)
Vol. 85, No. 1, Year 2012 (Cover Date: January 2012)
Journal Editor: Göke B. (Munich), Shinomura Y. (Sapporo)
ISSN: 0012-2823 (Print), eISSN: 1421-9867 (Online)
For additional information: http://www.karger.com/DIG