In response to the editorial on colon cancer reduction,1 we would like to point out an additional potentially severe complication associated with cancer screening using a flexible sigmoidoscope or colonoscope—the fairly high probability that the screened patient will be exposed to a contaminated endoscope. According to the US Preventive Services Task Force,2 "An individual's lifetime risk of dying of colorectal cancer in the U.S. has been estimated to be 2.6%." However, as researched by the US Food and Drug Administration and 3 state departments of health3: "A total of 23.9% of the bacterial cultures from the internal channels of 71 gastrointestinal endoscopes grew 100,000 colonies or more of bacteria." As a result, they report that "outbreaks with substantial morbidity and mortality have occurred."
Knapp DA, Michocki RJ, Mays DA. Endoscopists Need to Clean Up Their Act—Literally. Arch Intern Med. 1998;158(8):928. doi: