A comparison of unsedated colonoscopy and flexible sigmoidoscopy in the family medicine setting: an LA Net study.

BACKGROUND Colonoscopy visualizes more of the colon than flexible sigmoidoscopy. This study compares the outcomes of an unsedated modified colon endoscopy (MCE) with flexible sigmoidoscopy (FS) in family medicine practice. METHODS We conducted a retrospective chart review of existing clinical data to compare outcomes for 48 patients undergoing MCE and 35 patients undergoing FS at 3 family medicine practices in Los Angeles. Outcomes of interest included completion rates, number of complications, depth reached, anatomic site visualized, and information about the number and nature of clinical findings. RESULTS No significant differences were found between MCE and FS regarding completion rates (83.3% vs 75%, respectively). Expected statistically significant differences were found between the 2 procedures in the anatomic site visualized (P<.01) and depth reached (P<.01). Clinical pathologies were identified in 58% of MCE patients and 37% of FS patients. Four adenocarcinomas were identified in the MCE group in the proximal region of the colon that could not have been detected by FS. CONCLUSIONS Findings from this study suggest that MCE can be an acceptable alternative to FS in office settings for colorectal cancer screening.