Comparison of endoscopic procedures for colorectal cancer screening in women with mammography and Pap smear.

BACKGROUND: This study compared the experiences of women who underwent endoscopic screening for colorectal cancer vs. their experiences with breast and cervical cancer screening by mammography and Pap smear, respectively.
METHODS: Women who had either flexible sigmoidoscopy or colonoscopy as a screening procedure for colorectal cancer were asked to return a questionnaire by mail. In the questionnaire, they were asked about the procedure they had just undergone and to compare it with recent mammograms and Pap smears. Flexible sigmoidoscopy was performed without sedating the patient; colonoscopy was performed with the patient under deep sedation (midazolam, fentanyl, and propofol administered by an anesthesiologist).
RESULTS: Responses were obtained from 258 women (88%). Of these, 152 had colonoscopy and 106 had flexible sigmoidoscopy. A total of 72% of respondents found colonoscopy to be a comfortable test. Only 26% found flexible sigmoidoscopy uncomfortable, which was similar to mammography and Pap smear, at 22%. In terms of the test considered to be the most embarrassing, the highest response rate (38%) was for the Pap smear. Most women had no preference as to the gender of the endoscopist, but 46% preferred a woman doctor for a Pap smear (p < 0.001). Preparation was regarded as the worst part of the colonoscopy procedure; for flexible sigmoidoscopy, the procedure itself and the preparation were equivalent.
CONCLUSIONS: Women found flexible sigmoidoscopy or colonoscopy comfortable and less embarrassing than a Pap smear or a mammography. There was no preference with respect to the gender of the physician who performed the colorectal screening procedures, unlike the Pap smear. Most respondents would have the procedure again and would recommend it to others.