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ARTICLE |

Screening for Colorectal Cancer: Which Test Is Best? FREE

Milton S. Sakamoto, MD; Jay M. Schlumpberger, MD
JAMA. 1994;272(14):1100-1100. doi:10.1001/jama.1994.03520140029018
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To the Editor.  —We found the article by Drs Lang and Ransohoff1 on the utility of the FOBT screening for CRC very interesting. Their results suggest that one third to one half of the mortality reduction observed in the widely cited Minnesota Colon Cancer Control Study of FOBT screening using rehydrated slides2 may be attributable to chance selection for colonoscopy. They further assert that with long-term annual FOBT screening with rehydration the chance of undergoing colonoscopy approaches 100% and, therefore, it may be a more effective strategy to simply screen everyone directly with colonoscopy (eg, when a person reaches a certain age).We agree that universal endoscopic screening would be a more direct approach to screening for CRC. Such a direct approach would eliminate the annual costs of laboratory processing, record keeping, and follow-up associated with doing annual FOBT screening. We would further suggest that any universal endoscopic

REFERENCES

Lang CA, Ransohoff DF.  Fecal occult blood screening for colorectal cancer: is mortality reduced by chance selection for screening colonoscopy? JAMA . 1994;;271: 1011-1013.
Mandel JS, Bond JH, Church TR, et al.  Reducing mortality from colorectal cancer by screening for fecal occult blood. N Engl J Med . 1993;;328:1365-1371.
Atkin WS, Cuzick J, Northover JMA, Whynes DK.  Prevention of colorectal cancer by once-only sigmoidoscopy. Lancet . 1993;;341:736-740.
Sakamoto MS, Hara JH, Schlumpberger JM.  Screening flexible sigmoidoscopy in a low-risk, highly screened population. J Fam Pract . 1994;;38:245-248.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Lang CA, Ransohoff DF.  Fecal occult blood screening for colorectal cancer: is mortality reduced by chance selection for screening colonoscopy? JAMA . 1994;;271: 1011-1013.
Mandel JS, Bond JH, Church TR, et al.  Reducing mortality from colorectal cancer by screening for fecal occult blood. N Engl J Med . 1993;;328:1365-1371.
Atkin WS, Cuzick J, Northover JMA, Whynes DK.  Prevention of colorectal cancer by once-only sigmoidoscopy. Lancet . 1993;;341:736-740.
Sakamoto MS, Hara JH, Schlumpberger JM.  Screening flexible sigmoidoscopy in a low-risk, highly screened population. J Fam Pract . 1994;;38:245-248.
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