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January 27, 1989, Vol 261, No. 4 >
ARTICLE | January 27, 1989

Mass Screening for Colorectal Cancer: Are We Ready?

Charles B. Clayman, MD
JAMA. 1989;261(4):609. doi:10.1001/jama.1989.03420040147036.
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Considerable funds have gone toward publicizing mass screening for breast cancer and cervical cancer; however, less aggressive efforts have been extended in the area of colorectal cancer (CRC) and its precursors. In this issue of The Journal is an article authored by a committee of the American Gastroenterological Association and the American Society for Gastrointestinal Endoscopy.1 The article recommends, without specifying frequency, a digital rectal examination from age 40 years and fecal occult blood tests (FOBT) and flexible sigmoidoscopy from age 50 years for everyone in the average-risk population.

In the case of an FOBT with positive results, they advise colonoscopy in every instance. An objective observer would almost surely differ with the advice offered. The air-contrast barium enema examination (ACBEE) with flexible sigmoidoscopy used in the event colonoscopy is not available is relegated to an alternative role. This despite the calculated superior sensitivity of ACBEE when compared with

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