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July 13, 1979, Vol 242, No. 2 >
ARTICLE | July 13, 1979

Colorectal Cancer Screening-Reply

Morton J. Goodman, MD
JAMA. 1979;242(2):140. doi:10.1001/jama.1979.03300020014007.
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ABSTRACT

In Reply.—  I share Dr Bharath's concern regarding unnecessary diagnostic workups because of false-positive results in guaiac screens for occult blood in the stool. An acceptable level for false-positivity has not been agreed on. Certainly the 4.3% reported by Winawer seems to be too high. Our protocol does not permit accurate assessment of our rate.We deplore uncomfortable, expensive, diagnostic bowel studies that may be unnecessary; however, this disturbs us less because we are finding early colon cancer. Of eight cancers our program has detected to date (in 2,800 persons screened), six of them were in Duke's stage A, with no penetration of the bowel wall.However, other problems with the HO II slide have now surfaced in our program. It appears that the HO II test may be more sensitive than the old HO, although the manufacturer denies it. This has led to some concern regarding batch variations and

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