Flexible sigmoidoscopy misses a majority of advanced polyps and cancers in women of average risk

Women who have only the lower part of their colons examined for polyps and cancer may be at an even greater disadvantage than men. During colonoscopies in over 1,460 women, doctors measured the amount of advanced neoplasia found beyond the reach of a flexible sigmoidoscope. Advanced neoplasia included polyps larger than 1 centimeter, polyps with many precancerous cells, and cancer.

Such advanced neoplasia would have been found in only about a third of women (35.2%). Two-thirds (65%) would have been missed.

Advanced neoplasia was found in 72 women (4.9%). Only 25 women (1.7%) would have been diagnosed by flexible sigmoidoscopy. The other 47 (3.2%) would have not have had cancer or serious pre-cancerous lesions found.

The reseachers compared the results of their study to similar men in the VA Cooperative Study. In men, 66.3% had neoplasia that could be diagnosed with sigmoidoscopy, putting women at higher risk for a missed polyp or cancer when the entire colon is not examined during screening.

Philip Schoenfield, M.D. led the study. The team concluded that colonoscopy may be the preferred method of colorectal screening for women.

Results of the CONCeRN study were reported in the May 19, 2005 issue of the The New England Journal of Medicine.

Read the study abstract in The New England Journal of Medicine.

Read an article about the study from Reuters Health.

Read an article about the study on Medscape.