Feasibility of sigmoidoscopic screening for bowel cancer in a primary care setting.

Sigmoidoscopic screening for bowel cancer is controversial because of its debatable efficacy, lack of patient and physician acceptance of the procedure, and uncertainty about its practicality with the large numbers of patients in primary care settings. This study addressed patient acceptance and practicality. During an 18-month period, 75 percent of all patients aged 50 years and greater who were seen for health maintenance accepted sigmoidoscopy. The procedure was integrated into office routines without disrupting other patient care. While compliance with fecal occult blood testing was high (88 percent), sensitivity of this test for neoplastic polyps within reach of the proctosigmoidoscope was low (11 percent). These results suggest that acceptance of sigmoidoscopy by patients seen in family physicians' offices could be greater than has been anticipated.