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ARTICLE |

Mass Screening for Colorectal Cancer: Are We Ready? FREE

Charles B. Clayman, MD
JAMA. 1989;261(4):609-609. 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

REFERENCES

Fleischer DE, Goldberg SB, Browning TH, et al:  Detection and surveillance of colorectal cancer . JAMA 1989;;261:580-585.
Brandeaw ML, Eddy DM:  The workup of the asymptomatic patient with a positive fecal occult blood test . Med Decis Making 1987;;7:32-46.
Knight KK, Fielding JE, Battista RN:  Occult blood screening for colorectal cancer . JAMA 1989;;261:586-593.
Selby JV, Friedman GD:  Sigmoidoscopy in the periodic health examination of asymptomatic adults . JAMA 1988;;261:594-601.
American Cancer Society:  Cancer of the colon and rectum . CA 1980;;30:208-215.
Benefits for Screening and Preventive Services . Chicago, Blue Cross and Blue Shield Association, 1988;.
Statistical Abstract of the United States , ed 17. US Dept of Commerce, Bureau of the Census, 1988;.
Clayman DB:  Mass screening: Is it cost-effective? JAMA 1980;;243:2067-2068.

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Fleischer DE, Goldberg SB, Browning TH, et al:  Detection and surveillance of colorectal cancer . JAMA 1989;;261:580-585.
Brandeaw ML, Eddy DM:  The workup of the asymptomatic patient with a positive fecal occult blood test . Med Decis Making 1987;;7:32-46.
Knight KK, Fielding JE, Battista RN:  Occult blood screening for colorectal cancer . JAMA 1989;;261:586-593.
Selby JV, Friedman GD:  Sigmoidoscopy in the periodic health examination of asymptomatic adults . JAMA 1988;;261:594-601.
American Cancer Society:  Cancer of the colon and rectum . CA 1980;;30:208-215.
Benefits for Screening and Preventive Services . Chicago, Blue Cross and Blue Shield Association, 1988;.
Statistical Abstract of the United States , ed 17. US Dept of Commerce, Bureau of the Census, 1988;.
Clayman DB:  Mass screening: Is it cost-effective? JAMA 1980;;243:2067-2068.
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