Abstract
Colonoscopy as the initial test for rectal bleeding could delay diagnosis of rectal and left sided colon cancer, since colonoscopy generally requires sedation and bowel preparation. In 2014, our tertiary veterans hospital instituted a protocol wherein primary care, emergency room, and other providers were instructed to direct patients with rectal bleeding to the endoscopy unit for unsedated sigmoidoscopy on the same day that they reported symptoms. The aim of our study was to determine whether this day of symptoms sigmoidoscopy (DOSS) program decreased time to diagnosis of rectal and left-sided colon cancer, and resulted in an earlier stage at initial diagnosis.
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