Gastroenterology
Volume 122, Issue 5 , Pages 1226-1234 , May 2002

On-site screening sigmoidoscopy promotes long-term utilization but fails as a venue for training primary care endoscopists

  • Paul C. Schroy III

      Affiliations

    • Department of Medicine, Boston Medical Center
    • Department of Epidemiology and Biostatistics, Boston University School of Public Health, Boston, Massachusetts
    • ,
  • Tim Heeren

      Affiliations

    • Department of Epidemiology and Biostatistics, Boston University School of Public Health, Boston, Massachusetts
    • ,
  • Charles M. Bliss

      Affiliations

    • Department of Medicine, Boston Medical Center
    • ,
  • Charles M. Bliss Jr.

      Affiliations

    • Department of Medicine, Boston Medical Center
    • ,
  • Jon Pincus

      Affiliations

    • Department of Medicine, Boston Medical Center
    • ,
  • Sheila Wilson

      Affiliations

    • Department of Medicine, Boston Medical Center
    • ,
  • Marianne Prout

      Affiliations

    • Department of Epidemiology and Biostatistics, Boston University School of Public Health, Boston, Massachusetts

Received 10 September 2001 ,Accepted 24 January 2002.

References 

  1. Greenlee R. Cancer Statistics, 2001. CA Cancer J Clin. 2001;15:15–36
  2. Selby JV. Screening sigmoidoscopy for colorectal cancer. Lancet. 1993;341:728–729
  3. Newcomb PA, Norfleet RG, Storer BE, Surawicz TS, Marcus PM. Screening sigmoidoscopy and colorectal cancer mortality. J Natl Cancer Inst. 1992;84:1572–1575
  4. Muller AD, Sonnenberg A. Prevention of colorectal cancer by flexible endoscopy and polypectomy. A case-control study of 32,702 veterans. Ann Intern Med. 1995;123:904–910
  5. Wagner J, Tunis S, Brown ML, Ching A, Almeida R. Cost-effectiveness of colorectal cancer screening in average-risk adults. In:  Young G,  Levin B editor. Prevention and early detection of colorectal cancer. London: Saunders; 1996;
  6. Frazier AL, Colditz GA, Fuchs CS, Kuntz KM. Cost-effectiveness of screening for colorectal cancer in the general population. JAMA. 2000;284:1954–1961
  7. Loeve F, Brown ML, Boer R, van Ballegooijen M, van Oortmarssen GJ, Habbema JD. Endoscopic colorectal cancer screening: a cost-saving analysis. J Natl Cancer Inst. 2000;92:557–563
  8. Winawer SJ, Fletcher RH, Miller L, Godlee F, Stolar MH, Mulrow CD, et al. Colorectal cancer screening: clinical guidelines and rationale. Gastroenterology. 1997;112:594–642
  9. Force USPST . Guide to clinical preventive services. In: 2nd ed. Baltimore: Williams & Wilkins; 1996;p. 89–103
  10. Smith RA, Mettlin CJ, Davis KJ, Eyre H. American Cancer Society guidelines for the early detection of cancer. CA Cancer J Clin. 2000;50:34–49
  11. Cooper GS, Fortinsky RH, Hapke R, Landefeld CS. Factors associated with the use of flexible sigmoidoscopy as a screening test for the detection of colorectal carcinoma by primary care physicians. Cancer. 1998;82:1476–1481
  12. Cooper GS, Yuan Z, Veri L, Rimm AA, Stange KC. Colorectal carcinoma screening attitudes and practices among primary care physicians in counties at extremes of either high or low cancer case fatality. Cancer. 1999;86:1669–1674
  13. Schoen RE, Weissfeld JL, Kuller LH. Sigmoidoscopy use among primary care physicians. Prev Med. 1995;24:249–254
  14. Schroy PC, Heeren T, Bliss CM, Pincus J, Wilson S, Prout M. Implementation of on-site screening sigmoidoscopy positively influences utilization by primary care providers. Gastroenterology. 1999;117:304–311
  15. DiSario JA, Sanowski RA. Sigmoidoscopy training for nurses and resident physicians. Gastrointest Endosc. 1993;39:29–32
  16. Schertz RD, Baskin WN, Frakes JT. Flexible fiberoptic sigmoidoscopy training for primary care physicians: results of a 5-year experience. Gastrointest Endosc. 1989;35:316–320
  17. Lewis JD, Asch DA. Barriers to office-based screening sigmoidoscopy: does reimbursement cover costs?. Ann Intern Med. 1999;130:525–530
  18. Lewis JD, Asch DA, Ginsberg GG, Hoops TC, Kochman ML, Bilker WB, et al. Primary care physicians' decisions to perform flexible sigmoidoscopy. J Gen Intern Med. 1999;14:297–302
  19. Lomas J, Haynes R. A taxonomy and critical review of tested strategies for the application of clinical practice recommendations: from “official” to “individual” clinical policy. Am J Prev Med. 1988;4:101–107
  20. Lewis JD, Ginsberg GG, Hoops TC, Kochman ML, Bilker WB, Strom BL. Flexible sigmoidoscopy training and its impact on colorectal cancer screening by primary care physicians. Arch Fam Med. 2000;9:420–425
  21. Shaukat M, Ramirez FC. The utilization of flexible sigmoidoscopy by family practitioners after residency training. Gastrointestinal Endoscopy. 2000;52:45–47
  22. Schoenfeld P, Lipscomb S, Crook J, Dominguez J, Butler J, Holmes L, et al. Accuracy of polyp detection by gastroenterologists and nurse endoscopists during flexible sigmoidoscopy: a randomized trial. Gastroenterology. 1999;117:312–318
  23. Schoenfeld PS, Cash B, Kita J, Piorkowski M, Cruess D, Ransohoff D. Effectiveness and patient satisfaction with screening flexible sigmoidoscopy performed by registered nurses. Gastrointest Endosc. 1999;49:158–162
  24. Wallace MB, Kemp JA, Meyer F, Horton K, Reffel A, Christainsen CL, et al. Screening for colorectal cancer with flexible sigmoidoscopy by nonphysician endoscopists. Am J Med. 1999;107:214–218
  25. Maule WF. Screening for colorectal cancer by nurse endoscopists. N Engl J Med. 1994;330:183–187
  26. Schoen RE, Weissfeld JL, Bowen NJ, Switzer G, Baum A. Patient satisfaction with screening flexible sigmoidoscopy. Arch Intern Med. 2000;160:1790–1796
  27. Tuggy ML. Virtual reality flexible sigmoidoscopy simulator training: impact on resident performance. J Am Board Fam Pract. 1998;11:426–433
  28. Rodney WM, Beaber RJ, Johnson R, Quan M. Physician compliance with colorectal cancer screening (1978–1983): the impact of flexible sigmoidoscopy. J Fam Pract. 1985;20:265–269
  29. Rodney WM, Felmar E, Auslander M. AAFP–ASGE conjoint course on flexible sigmoidoscopy. Fam Pract Res J. 1986;5:209–215
  30. Rodney WM, Albers G. Flexible sigmoidoscopy: primary care outcomes after two types of continuing medical education. Am J Gastroenterol. 1986;81:133–137
  31. Sheinfeld Gorin S, Gemson D, Ashford A, Block S, Lantigua R, Ahsan H, et al. Cancer education among primary care physicians in an underserved community. Am J Prev Med. 2000;19:53–58
  32. Lieberman DA, Weiss DG, Bond JH, Ahnen DJ, Garewal H, Chejfec G. Use of colonoscopy to screen asymptomatic adults for colorectal cancer. Veterans Affairs Cooperative Study Group 380 N Engl J Med. 2000;343:162–168
  33. Imperiale TF, Wagner DR, Lin CY, Larkin GN, Rogge JD, Ransohoff DF. Risk of advanced proximal neoplasms in asymptomatic adults according to the distal colorectal findings. N Engl J Med. 2000;343:169–174
  34. Charles C, Gafni A, Whelan T. Decision making in the physician–patient encounter: revisiting the shared treatment decision making model. Soc Sci Med. 1999;49:651–661

☆ Address requests for reprints to: Paul C. Schroy III, M.D., M.P.H., Boston Medical Center, E201, 88 East Newton Street, Boston, Massachusetts 02118. e-mail: paul.schroy@bmc.org; fax: (617) 638-7785.

☆☆ Supported by National Cancer Institute Preventive Oncology Academic Award KO7-CA68058 (to P.C.S.).

PII: S0016-5085(02)99596-X

Gastroenterology
Volume 122, Issue 5 , Pages 1226-1234 , May 2002

Article Tools

* Image Usage & Resolution