Detection and Surveillance of Colorectal Cancer-Reply

In Reply.—  We agree that colon cancer should be placed in perspective. In 1988, there were more than 147 000 new cases and 61500 deaths from the disease in the United States alone.¹ Recent advances in our knowledge about the natural history of colon cancer, risk factors, the relationship between stage of disease and survival, diagnostic methods, and surgical treatment are beginning to have a favorable impact after decades of relative stagnation. Physicians need to apply current methods to their patients now to prevent advanced cancer. They cannot wait until "proof" of the value of screening and surveillance is provided by controlled studies, but must make intelligent choices between available options. Recognizing the importance of this "case finding," the American Gastroenterological Association and the American Society for Gastrointestinal Endoscopy prepared the guideline article entitled "Detection and Surveillance of Colorectal Cancer." This unprecedented joint effort employed available data plus the