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Factors associated with inadequate colorectal cancer screening with flexible sigmoidoscopy . BACKGROUND AND STUDY AIM Inadequate colorectal cancer screening wastes limited endoscopic resources . We examined patients factors associated with inadequate flexible sigmoidoscopy ( FSG ) screening at baseline screening and repeat screening 3-5 years later in 10 geographically-dispersed screening centers participating in the ongoing Prostate , Lung , Colorectal , and Ovarian Cancer Screening Trial . METHODS A total of 64,554 participants ( aged 55-74 ) completed baseline questionnaires and underwent FSG at baseline . Of these , 39,385 participants returned for repeat screening . We used logistic regression models to assess factors that are associated with inadequate FSG ( defined as a study in which the depth of insertion of FSG was < 50 cm or visual inspection was limited to < 90 % of the mucosal surface but without detection of a polyp or mass ) . RESULTS Of 7084 ( 11 % ) participants with inadequate FSG at baseline , 6496 ( 91.7 % ) had < 50 cm depth of insertion ( 75.3 % due to patient discomfort ) and 500 ( 7.1 % ) participants had adequate depth of insertion but suboptimal bowel preparation . Compared to 55-59 year age group , advancing age in 5-year increments ( odds ratios ( OR ) from 1.08 to 1.51 ) and female sex ( OR = 2.40 ; 95 % confidence interval ( CI ) : 2.27-2.54 ) were associated with inadequate FSG . Obesity ( BMI > 30 kg/m ( 2 ) ) was associated with reduced odds ( OR = 0.67 ; 95 % CI : 0.62-0.72 ) . Inadequate FSG screening at baseline was associated with inadequate FSG at repeat screening ( OR = 6.24 ; 95 % CI : 5.78-6.75 ) . CONCLUSIONS Sedation should be considered for patients with inadequate FSG or an alternative colorectal cancer screening method should be recommended .
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Intervention_Physical
colorectal cancer screening with flexible sigmoidoscopy
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Intervention_Physical
flexible sigmoidoscopy
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Intervention_Physical
repeat screening
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Intervention_Physical
FSG
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Intervention_Physical
repeat screening
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Intervention_Educational
inadequate
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Intervention_Physical
FSG
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Intervention_Physical
alternative colorectal cancer screening method
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Outcome_Physical
Obesity
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Participant_Condition
Prostate , Lung , Colorectal , and Ovarian Cancer
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Participant_Sample-size
64,554 participants
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Participant_Age
aged 55-74 )
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Participant_Sample-size
39,385