The role of flexible sigmoidoscopy in the preoperative screening of patients with inguinal hernia. A high yield of neoplasms

B. G. Rubin, G. H. Ballantyne, M. J. Zdon, K. A. Zucker and I. M. Modlin

Disagreement persists as to whether all patients with inguinal hernia should undergo screening examinations for colorectal cancers before hernia repair. The purpose of this study was to prospectively evaluate the effectiveness of flexible sigmoidoscopy (FS) as a screening examination for these patients. In an 18-month period, 110 patients with inguinal hernia (99% men) with an average age of 63 +/- 10 years underwent FS. Diverticulosis was found in 36% of the patients, colorectal polyps in 26%, and colorectal cancers in 3.6%. Occult blood was found in the stool of only 11% of these patients and, thus, was an ineffective screening test. These results suggest that FS is an effective means of screening for premalignant and malignant colorectal lesions in patients with inguinal hernias.