Procedure-Related Abdominal Discomfort in Patients Undergoing Colorectal Cancer Screening: A Comparison of Colonoscopy and Flexible Sigmoidoscopy

Zubarik, Richard; Ganguly, Eric K.; Benway, Donna; Ferrentino, Nicholas; Moses, Peter L.; Vecchio, J

doi:10.1111/j.1572-0241.2002.07101.x

Cited by 54 publications

(23 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…99 The absence of sedation is perceived by some patients as an advantage and by others as a disadvantage, although in one series, a greater percentage of patients undergoing sigmoidoscopy reported periprocedural discomfort (during and postexam) compared with patients undergoing colonoscopy. 100 Moreover, lack of sedation is associated with greater patient discomfort and greater patient reluctance to undergo the examination for future screening. 100 An additional limitation of FSIG is that there may be considerable variation both in depth of insertion of the scope and in adenoma detection at FSIG between different examiners, 94,101 and this may reduce the effectiveness of FSIG for CRC screening, especially in practice settings of low volume.…”

Section: Fsigmentioning

confidence: 99%

“…100 Moreover, lack of sedation is associated with greater patient discomfort and greater patient reluctance to undergo the examination for future screening. 100 An additional limitation of FSIG is that there may be considerable variation both in depth of insertion of the scope and in adenoma detection at FSIG between different examiners, 94,101 and this may reduce the effectiveness of FSIG for CRC screening, especially in practice settings of low volume. Quality assurance is an important issue for flexible sigmoidoscopists and has been reviewed in detail elsewhere.…”

Section: Fsigmentioning

confidence: 99%

“…Patients in the same practice who had undergone unsedated FSIG screening were more than twice as likely to say that they would not return for additional screening compared with those who had undergone colonoscopy with sedation. 100 Colonoscopy has several limitations. It requires one or more days of dietary preparation and bowel cleansing, usually a day dedicated to the examination, and because of sedation, a chaperone is needed for transportation.…”

Section: Colonoscopymentioning

confidence: 99%

See 2 more Smart Citations

Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology

Levin

Lieberman

McFarland

et al. 2008

CA: A Cancer Journal for Clinicians

1,567

916

View full text Add to dashboard Cite

In the United States, colorectal cancer (CRC) is the third most common cancer diagnosed among men and women and the second leading cause of death from cancer. CRC largely can be prevented by the detection and removal of adenomatous polyps, and survival is significantly better when CRC is diagnosed while still localized. In 2006 to 2007, the American Cancer Society, the US Multi Society Task Force on Colorectal Cancer, and the American College of Radiology came together to develop consensus guidelines for the detection of adenomatous polyps and CRC in asymptomatic average-risk adults. In this update of each organization's guidelines, screening tests are grouped into those that primarily detect cancer early and those that can detect cancer early and also can detect adenomatous polyps, thus providing a greater potential for prevention through polypectomy. When possible, clinicians should make patients aware of the full range of screening options, but at a minimum they should be prepared to offer patients a choice between a screening test that is effective at both early cancer detection and cancer prevention through the detection and removal of polyps and a screening test that primarily is effective at early cancer detection. It is the strong opinion of these 3 organizations that colon cancer prevention should be the primary goal of screening. (CA Cancer J Clin 2008;58:130-160.)

show abstract

Section: Fsigmentioning

confidence: 99%

Section: Fsigmentioning

confidence: 99%

Section: Colonoscopymentioning

confidence: 99%

See 1 more Smart Citation

Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology

Levin

Lieberman

McFarland

et al. 2008

CA: A Cancer Journal for Clinicians

1,567

916

View full text Add to dashboard Cite

show abstract

“…8 The tolerance of this procedure has been the subject of assessment and 19% of patients said they would not undergo the procedure again without some form of anaesthesia. 9 Procedure-related pain is an important issue in prostate cancer diagnosis as so many patients will have to undergo a second or third biopsy, their perception of discomfort at the first biopsy can influence whether they are willing to undergo the procedure again; this has been demonstrated as an important determinant in screening programmes. 9 Interestingly, in our study, we found no significant difference between the two groups, and this was surprising considering the enthusiasm of other authors.…”

Section: Discussionmentioning

confidence: 99%

“…9 Procedure-related pain is an important issue in prostate cancer diagnosis as so many patients will have to undergo a second or third biopsy, their perception of discomfort at the first biopsy can influence whether they are willing to undergo the procedure again; this has been demonstrated as an important determinant in screening programmes. 9 Interestingly, in our study, we found no significant difference between the two groups, and this was surprising considering the enthusiasm of other authors. We did however make an effort to evaluate the discomfort associated with the overall procedure, and not just with the biopsy itself.…”

Section: Discussionmentioning

confidence: 99%

A randomised trial of periprostatic local anaesthetic for transrectal biopsy

Walsh

O’Brien

Salemmi

et al. 2003

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

Increasingly transrectal ultrasound and biopsy is performed for the detection of prostate cancer. We have conducted a randomised trial to evaluate whether the addition of periprostatic local anaesthetic injection reduces the discomfort of the procedure. A total of 64 patients who attended a specialised prostate clinic and were being evaluated for an elevated prostate-specific antigen agreed to participate in the trial and were randomly allocated to two groups. The intervention group received 10 ml of 1% lignocaine in the periprostatic tissue prior to biopsy and the control group underwent a standard biopsy. All patients had a sextant biopsy under ultrasound guidance. After the procedure, they were asked to determine the severity of the pain on a scale of 0-10 and the whether the quality of the pain was mild, moderate or severe. The responses were distributed normally. The groups were compared using Student's t-test. Pain severity showed no significant difference between the two groups (P ¼ 0.14). There was a trend towards a statistical difference (P ¼ 0.07) on the qualitative pain scale. In conclusion, no significant difference in overall discomfort in men having sextant biopsies was detected between the two groups, suggesting that the administration of local anaesthetic may not be as valuable as early reports have suggested.

show abstract

Patient characteristics associated with easy and poor tolerance of moderate sedation during endoscopy

et al. 2019

View full text Add to dashboard Cite

Summary Background Appropriate levels of sedation are paramount for optimising patient comfort, safety and technical success during endoscopy. The goal of this cross‐sectional study was to identify factors associated with patient tolerance of moderate sedation during esophagogastroduodenoscopy (EGD) and colonoscopy. Methods Endoscopic procedures performed under moderate sedation from 2004 to 2018 at the NIH were reviewed. Patients were categorised as “poorly tolerated,” based on the assessment of the performing endoscopist, or “easily sedated,” based on low levels of sedation (fentanyl 50 mcg and midazolam ≤2 mg). Epidemiologic and anthropometric data, type of procedure, inpatient/outpatient status and benzodiazepine/opiate use were analysed and compared between the two sedation groups. Results Over a 14‐year period, 7590 endoscopies were assessed (4442 EGDs and 3148 Colonoscopies). A total of 359 patients met criteria for inclusion; 242 were categorised as “easy to sedate” (162 EGDs and 80 colonoscopies) and 118 as “difficult to sedate” (62 EGDs and 56 colonoscopies). For EGDs, younger age, African American race and nonscreening indication were associated with difficult sedation. For colonoscopies, young age, low/normal weight and White/African American race were all associated with more difficult sedation. Conclusions Patients who are female, young and have a lower BMI are more likely to poorly tolerate procedures with moderate sedation. Persons of Hispanic/Asian descent appear to tolerate moderate sedation significantly better than other races. Clinicians should be aware of these factors when determining the type of sedation that will optimise success of endoscopy.

show abstract

Procedure-Related Abdominal Discomfort in Patients Undergoing Colorectal Cancer Screening: A Comparison of Colonoscopy and Flexible Sigmoidoscopy

Cited by 54 publications

References 9 publications

Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology

Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology

A randomised trial of periprostatic local anaesthetic for transrectal biopsy

Patient characteristics associated with easy and poor tolerance of moderate sedation during endoscopy

Contact Info

Product

Resources

About