A new report shows that perforation of the colon is more likely if the whole colon is examined for cancer, compared to examination of just the lower section.

There are two procedures for screening people for colon cancer. In colonoscopy, the entire length of the colon is examined, while sigmoidoscopy involves examination of just the lower part. In both cases there is the possibility of perforation or damage to the wall of the colon which, in rare cases, may even be fatal. But the rate of this complication has not been known with any degree of accuracy, because of limited data.

In the first large study, by researchers at Columbia University, USA, the rate of perforation in nearly 40,000 colonoscopies was found to be around 1.96 per 1,000 procedures. In a group of over 35,000 sigmoidoscopies, the rate of perforation was around half at 0.88 perforations per 1,000 procedures. However, the gap has been narrowing over time as the risk of perforation in colonoscopy has been falling - probably because of improvements in technology.

This is useful information for doctors and patients as they choose which procedure is most appropriate for colon cancer screening in individual cases.

Source

Journal of the National Cancer Institute 5th February 2003