To the Editor.—
At a public, outpatient health center, we introduced rigid sigmoidoscopy as part of routine medical care for a population that previously had had little access to such screening. Our center is freestanding and tax supported, with a sliding fee scale, and no one is denied care because of inability to pay. Patients come for checkups or because of illnesses, and rigid sigmoidoscopy was offered to anyone over the age of 50 years who was a potential surgical candidate. Patients had to make a separate appointment for the sigmoidoscopy; a digital rectal examination and a stool guaiac test were done as part of routine examinations.
Preparation for the examination included a Fleet enema done by the patient at home just before leaving. At the examination, a guaiac test was done via digital rectal examination (if stool was present) and again after the sigmoidoscope had been inserted as
Bobrow RS. Colorectal Cancer at a Public Health Center. JAMA. 1987;257(6):782–783. doi:10.1001/jama.1987.03390060072024