CORRESPONDENCE

RESPONSE: Re: Risk of Perforation After Colonoscopy and Sigmoidoscopy: A Population-Based Study

Nicolle M. Gatto, Alfred I. Neugut, Harold Frucht

Affiliations of authors: N. M. Gatto (Department of Epidemiology), A. I. Neugut (Departments of Medicine and Epidemiology), H. Frucht (Department of Medicine), Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons and Mailman School of Public Health, Columbia University, New York, NY.

Correspondence to: Alfred I. Neugut, M.D., Ph.D., Division of Medical Oncology, New York-Presbyterian Hospital, 630 West 168th St., New York, NY 10032 (e-mail: ain1{at}columbia.edu).

We appreciate the comments by Schoen and Levin regarding our study of perforations during colonoscopy and sigmoidoscopy (1). With our dataset, we were unable to precisely pinpoint those asymptomatic individuals of average risk who were undergoing screening endoscopy. Instead, we compared all comers and indications in a population that was appreciably older than those in the studies cited by Schoen and Levin (24). Furthermore, compared with these other studies, our sample was population-based and was not within the context of outstanding referral centers or clinical trials, where lower perforation rates would be anticipated. The result was a dramatically higher perforation rate for sigmoidoscopy, although the rate of perforation for colonoscopy was more typical of the prior literature, perhaps reflecting that colonoscopy has only recently become a screening tool for the average-risk population.

REFERENCES

1 Gatto NM, Frucht H, Sundararajan V, Jacobson JS, Grann VR, Neugut AI. Risk of perforation after colonoscopy and sigmoidoscopy: a population-based study. J Natl Cancer Inst 2003;95:230–6.[Abstract/Free Full Text]

2 Levin TR, Conell C, Shapiro JA, Chazan SG, Nadel MR, Selby JV. Complications of screening flexible sigmoidoscopy. Gastroenterology 2002;123:1786–92.[CrossRef][ISI][Medline]

3 Single flexible sigmoidoscopy screening to prevent colorectal cancer: baseline findings of a UK multicentre randomised trial. Lancet 2002;359:1291–300.[CrossRef][ISI][Medline]

4 Anderson ML, Pasha TM, Leighton JA. Endoscopic perforation of the colon: lessons from a 10-year study. Am J Gastroenterol 2000;95:3418–22.[CrossRef][ISI][Medline]



             
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