Diagnosis of rectal and colon disease by the primary care physician.

Digital anorectal examination, combined with long proctoscopy, done without bowel preparation, constitutes a diagnostic tool remarkable for its comprehensive facility and for the basic role it plays in the systematic diagnosis of anorectal-colon disease. This venerable combination is a paragon of physical diagnosis with which flexible sigmoidoscopy cannot and need not compete. It is uniquely suited for use by the primary care physician in all his physical examinations and can greatly enhance early diagnosis of anorectal-colon cancer. It also has promising potential for mass screening. Clinical effectiveness of the procedure is evaluated in a survey of 1,200 patients in whom it was used.