Journal of Gastrointestinal Cancer

, Volume 38, Issue 2, pp 148–153

Relative Rates of Missed Diagnosis for Colonoscopy, Barium Enema, and Flexible Sigmoidoscopy in 379 Patients with Colorectal Cancer

Article

DOI: 10.1007/s12029-008-9027-x

Cite this article as:
Frenette, C.T. & Strum, W.B. J Gastrointest Canc (2007) 38: 148. doi:10.1007/s12029-008-9027-x

Abstract

Background

Failures of diagnosis of colorectal cancer by colonoscopy, barium enema, and flexible sigmoidoscopy have been demonstrated using various techniques. A relative assessment of these diagnostic tests for patients with colorectal cancer has not been reported. This study was designed to determine relative rates of failures for these tests when applied to diagnosis of colorectal cancer.

Methods

We created a database of patients with colorectal cancer diagnosed between 2000 and 2005. Records were reviewed for the results of colonoscopy, barium enema, and flexible sigmoidoscopy in the 3 years prior to diagnosis. An examination that was negative for cancer with no immediate follow-up was defined as a failure of diagnosis, either from inaccurate observation, failure to examine the entire colon, or failure of timely follow-up. The failure rates were compared.

Results

Three hundred seventy-nine patients, who had 421 examinations, were analyzed. The diagnosis of colorectal cancer failed in 60 of 379 patients (16%). These 60 patients had 71 examinations that failed to make the diagnosis: 25 of 282 colonoscopies (9%), 16 of 79 barium enemas (20%), and 30 of 60 flexible sigmoidoscopies (50%). These differences were statistically significant.

Conclusions

Failure rates for colonoscopy, barium enema, and flexible sigmoidoscopy were 9%, 20%, and 50%.

Keywords

colon cancer colonoscopy barium enema flexible sigmoidoscopy 

Abbreviations

BE

Barium enema

CRC

colorectal cancer

FOBT

Fecal occult blood test

FS

Flexible sigmoidoscopy

OC

Optical colonoscopy

Copyright information

© Humana Press Inc. 2008

Authors and Affiliations

  1. 1.Division of Gastroenterology and HepatologyScripps Clinic and The Scripps Research InstituteLa JollaUSA
  2. 2.San FranciscoUSA

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