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Flexible sigmoidoscopy in general practice
Author(s) -
Vellacott K. D.,
Clarke D.,
Beech C.,
Joshi H.
Publication year - 2002
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1046/j.1463-1318.2002.00326.x
Subject(s) - medicine , sigmoidoscopy , general practice , adenomatous polyps , yield (engineering) , general surgery , surgery , family medicine , colonoscopy , colorectal cancer , materials science , cancer , metallurgy
Objective Flexible sigmoidoscopy (FS) is increasingly being accepted as the method of choice for initial investigation of rectal bleeding and other lower gastrointestinal symptoms. The aim of this study was to assess the feasibility of FS in general practice and to compare the yield, cost and efficiency of a service provided by a consultant surgeon and a General Practitioner (GP). Subjects and methods A prospective study of FS was undertaken on 430 unsedated patients with symptoms suggestive of lower bowel disease in two general practices. Results The yield was comparable to hospital based data. Fifteen (3.5%) cancers were detected, of which 40% were Dukes A, and 46 (10.7%) adenomatous polyps. Cost per patient examination by a GP including capital costs, depreciation of equipment, and training was calculated to be cheaper or at least equivalent to a hospital‐based service but inefficient due to the low numbers examined per month. There were no complications and no missed cancers after a minimum follow up of 2 years. Conclusions The results suggest that FS can be safely performed by a suitably trained GP in health centres, but better utilization of equipment and value for money would be obtained by providing the service for a group of practices rather than a single practice as in this study.