Doctor Green wrote:Here's a story: I failed that day to get pre-approval for colonoscopy for a 57 y/o F who had a 3-4 week history of change in bowel habits, being more constipated (never had a colon study in the past, heme negative!). They will approve sigmoidoscopy &/or barium enema (quite insulting).
I must agree that a tumor which causes changes in bowel habits should
be large enough to be reliably detected by Barium Enema and sigmoidoscopy.
Therefore I am quite happy with these two when these are the presenting
The colonoscopy is more sensitive, but the missed BE lesions are the small
cancers or polyps that present with anemia and occult or overt bleeding.
Or do you have contradictory data? I would be happy to see the reference,
perhaps we ought to change our practice.