Screening colonoscopy—can we afford the cost?


diarrhea (10%). Prior imaging studies (CT scan and ultrasound) revealed no colon involvement. Barium enema was performed in 20 pts (results: sigmoid narrowing 12, sigmoid polyp 2, normal 6). FS was performed in 14 pts and colonoscopy in 64 pts. Findings included: sigmoid metastasis 3 pts (4%, ovarian 2, uterine 1), adenomatous polyps 15 pts (20%, 11/15 over age 50, size: 2–10 mm, number: 1–2, location: rectosigmoid 8, desc colon 1, splenic flexure 1, transverse colon 1 [pathology: high grade dysplasia], hepatic flexure 1, cecum 2), radiation colitis 2 pts (3%), diverticulosis 15 pts (20%). Colonoscopy was incomplete in 20/64 pts (31%, extrinsic stricture 13, redundant colon 4, poor prep 2, pt discomfort 1). Surgical specimen revealed sigmoid colon involvement in 21 pts (29%, ovarian 16, uterine 5). GI symptoms did not correlate with colon involvement (p 5 NS). Conclusions: There is high incidence of intrinsic and extrinsic sigmoid colon metastasis in pts with ovarian and uterine malignancy. Prevalence of adenomatous polyps in pts with Gyn malignancies is higher compared to the general population. Although colonoscopy has the advantage of detecting proximal colon polyps, FS in pre-op staging of Gyn malignancy appears adequate. Further prospective studies with larger sample are warranted.

DOI: 10.1111/j.1572-0241.2000.02828.x

Cite this paper

@article{Provenzale2000ScreeningCW, title={Screening colonoscopy—can we afford the cost?}, author={Dawn T Provenzale and Rick K. Homan and Eugene Oddone}, journal={American Journal of Gastroenterology}, year={2000}, volume={95}, pages={2547-2547} }