EVIDENCE OF GENDER BIAS IN PATIENTS UNDERGOING FLEXIBLE SIGMOIDOSCOPY

Some studies have revealed gender bias against women in various aspect s of medical care. There is no substantial evidence of gender bias in patients undergoing cancer evaluations, specifically colorectal cancer screening and diagnosis of colorectal complaints. This study was desi gned to examine the role of gender bias related to patients undergoing flexible sigmoidoscopy. At the University of South Florida, we conduc ted a retrospective study of 1910 patients at three distinct flexible sigmoidoscopy clinics over several years, through 1992. The proportion s of male and female patients who underwent the procedure for indicati ons of either screening for colorectal cancer or the diagnosis of colo rectal complaints were determined. These proportions were compared wit h the respective male and female patient proportions from the total nu mber of currently active patients at each site who were eligible to ha ve the procedure for an appropriate indication. At all three sites, a significantly smaller proportion of women (p < 0.01) underwent the pro cedure than expected. This was true for both screening and diagnostic indications. Conversely, at all sites significantly more men (p < 0.01 ) underwent the procedure for both indications. The results of this st udy suggest gender bias against women for patients undergoing flexible sigmoidoscopy for both screening and diagnosis. This bias may adverse ly affect the lethality of colorectal cancer in women. It is important to determine if such biases are influenced by the physician's recomme ndation or mainly due to patient attitudes.