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Rigid sigmoidoscopy remains part of the initial clinical assessment for patients referred via the suspected colorectal cancer “Two-week-wait” pathway. It may be limited by lack of bowel preparation and pain; thus its usefulness has been questioned given subsequent formal luminal investigations. Aims were to evaluate patient experience with outpatient clinic rigid sigmoidoscopy and sensitivity of the procedure. Methods: A prospectively maintained database of consecutive patients attending colorectal rapid access clinics at a UK district general hospital was analysed. Subjective patient experience was assessed using a validated 8-part questionnaire. Accuracy of sigmoidoscopy findings was evaluated by subsequent investigation findings. Results: 135 patients were included. The procedure was abandoned in 7 patients (5.2%) due to pain or faecal loading. One rectal tumour was suspected on rigid sigmoidoscopy which was subsequently proven malignant. No additional cancers were missed at initial sigmoidoscopy, however only 20% benign rectal polyps were detected. 49.6% of patients did not expect the procedure and 45.2% felt anxious about it. 97% would be willing to have future rigid sigmoidoscopy. Discussion and Conclusions: Rigid sigmoidoscopy remains a useful assessment but has potential to miss pathology. Most patients were satisfied with their experience of rigid sigmoidoscopy; however, many did not expect the procedure during their consultation. Patients should be better informed and educated of what to expect at time of primary care referral.

Surgeon and Patient Experience of Rigid Sigmoidoscopy in Colorectal Rapid Access Clinic- How Useful is it?