Colon and Rectal Surgery Education Research Women in Surgery

The Importance of Comfort: Patient Gender Selection in Colorectal Surgery

Colorectal surgeons specialize in forms of inflammatory bowel disease (ulcerative colitis, Crohn’s disease and diverticulitis), colorectal cancer and pelvic floor disorders along with benign growths like polyps or hemorrhoids. Research has suggested sex- and gender-associated differences factor into the development of colorectal disease, including cancer. These conditions are often sensitive and private for patients, and it is important for them to seek a doctor who makes medical intervention comfortable.

Colorectal surgeons at the Washington University School of Medicine understand this concern, which often involves the selection of a doctor based on the patient’s and surgeon’s gender identities. A recent clinical study from the Section of Colon and Rectal Surgery, published in the American Journal of Surgery, found that patients often make a gender-based request when seeking treatment for problems they consider private.

Understanding Colorectal Health

Colorectal health plays a vital role in the digestive system and overall wellbeing. This portion of the body is integral to the gastrointestinal tract, and issues in the colon or rectum can produce chronic or acute health problems that impact daily living. Inflammatory bowel disease (IBD) can cause lifelong inflammation of the digestive tract. Colorectal cancer can lead to the partial or complete removal of the affected area. Pelvic floor disorders may cause extreme discomfort and difficulty passing bowel movements normally.

Of particular concern in terms of health risk is colorectal cancer, which has increasing prevalence in recent years. According to the American Cancer Society, colorectal cancer is the third most common cancer and cause of cancer death. It is essential for those eligible for colorectal screens or at high risk to develop this condition to undergo regular screenings. Population screening strategies have increased patient survival by detecting localized, early stages of the disease. Anyone above the age of 45 is encouraged to attend a screening, as young-onset colorectal cancer rates have witnessed a trend over recent decades.

Sex- and Gender-Specific Risks of Colorectal Conditions

Some colorectal conditions – including cancer – impact people differently. Colorectal cancer appears to be one of these diseases, as its incidence is 45-50% higher in biological males than females. Different types of colorectal cancers also occur at different frequencies among the sexes. This variation may be related to their biological sex and anatomy, such as different regulation rates of shared hormones like estrogen and testosterone.

Gender may also contribute to variable risk, as gender-specific life experiences and lifestyle patterns such as diet differ and can lead to different risk levels for developing colorectal conditions. In colorectal cancer, for example, diet, exercise and other lifestyle factors have been associated with CRC risk, and behaviors that increase development of CRC vary among genders. Recent clinical research has sought to understand sex- and gender-related biological and socio-cultural differences in colorectal cancer risk to then understand how these conditions are best treated.

Gender-Specific Colorectal Treatment

Gender disparities exist in the occurrence of colorectal disease, but there is also a divide in the frequency of screening and subsequent detection or treatment of colorectal disease. Studies on colorectal screening programs have suggested women are less likely to attend screening appointments or promotional events. This may in part be related to the belief that colorectal cancer and other colorectal conditions are considered “male” diseases due to a higher risk rates among biological males.

In contrast, men tend to hesitate to attend screenings more than women if they are not experiencing life-impacting symptoms. Such a delay can lead to diagnosis of a colorectal condition later in the process and potentially require more aggressive treatment. Five-year survival rates for early-stage colorectal cancer, for example, are nearly 90%, but survival rates at more advanced CRC can be as low as 15%.

Non-invasive fecal blood tests and colonoscopies are the standard for screening conditions like CRC, as they promote early detection of asymptomatic diseases. Population screening strategies have a survival benefit by detecting more early-stage problems. An obstacle occurs, however, when patients are concerned about the privacy or comfort they will experience while undergoing colorectal screening or treatment. A considerable percentage of patients make gender requests for their surgeons when seeking treatment. When a patient perceives their health concern as private, studies have shown they prefer a same-gender surgeon, suggesting there is comfortability in the sense of a shared identity or experience. This phenomenon is also common for patients seeking colorectal treatment or screening due to the nature of where colorectal disease occurs and the types of examinations necessary to detect them.

In a recent study conducted by Washington University physicians, patients expressed preference for a gender-concordant physician 17% of the time. Female patients have been found to seek same-gender physicians more frequently than male patients, leading to a necessity to have female surgeons available for the patient population.

The researchers concluded any colorectal department should be considerate of the sensitive nature of their patients’ perception of their condition. Additionally, diversifying their physician representation according to patient identity will create a safer environment for delivering patient-oriented care. Gender diversity in colorectal departments helps promote the treatment of patients of any gender who may otherwise be less likely to attend these essential health check-ins.

The Colorectal Division and Female-Identifying Surgeons

The Washington University School of Medicine Section of Colon and Rectal Surgery is a leader in the treatment as well as research in colorectal surgery and offers advanced treatment for those with colorectal conditions. Colorectal surgeons are trained to provide comprehensive care, use advanced surgical techniques and address all the concerns of their patients. They treat colorectal cancer, Crohn’s disease and ulcerative colitis among many other colorectal conditions. Examples of surgical procedures include transanal endoscopic microsurgical (TEM) excision and minimally invasive laparoscopic surgery that promotes shortened recovery time for patients.

Dr. Kerri Ohman

With this breadth of knowledge and innovative practices, the department is also equipped to handle the personal comfort of its patients. The department is mindful of the sensitive nature of many colorectal conditions and prioritizes the comfort of its patients. In recent years, the department has diversified its surgeon roster to create an optimized, considerate system for patient-centered care.

Dr. Radhika Smith

Two female-identifying surgeons bring an indispensable resource to the department and patients alike. Kerri A. Ohman, MD, and Radhika K. Smith, MD, provide expertise on diagnosing and treating colorectal cancers, IBD, pelvic floor disorders, polyps and hemorrhoids. Female-identifying surgeons are one of many ways the Section of Colon and Rectal Surgery seeks to make medical treatment accessible to all patients.

Contacting the Section of Colon and Rectal Surgery

Dr. Ohman sees patients at Christian Hospital in North St. Louis County. Dr. Smith sees patients at Barnes-Jewish West County Hospital and the Center for Advanced Medicine – South County. Representation of female surgeons at both hospitals provides access to more diverse groups of doctors closer to our patients.

Washington University Colon and Rectal Surgery is committed to helping you manage your health and is now offering virtual patient visits. To schedule a virtual visit with a specialist, please call 314-454-7177 or request an appointment through our online form.