TY - JOUR T1 - SCreening colonoscopy vs flexible sigmoidoscopy AU - Xirasagar S, Bennett CL, Hebert JR Y1 - 2010/11/10 N1 - 10.1001/jama.2010.1584 JO - JAMA SP - 2016 EP - 2018 VL - 304 IS - 18 N2 - To the Editor: The Commentary by Drs Neugut and Lebwohl1 illustrated an increasing ambivalence toward screening colonoscopy (vs flexible sigmoidoscopy or fecal occult blood testing [FOBT]) due to reported modest protection rates in recent population-based studies of colonoscopy. These community-based studies examined protection rates following colonoscopies performed by practicing gastroenterologists (including, in some studies, a small minority performed by primary care physicians). A little-emphasized feature of these studies was the lack of performance standardization on any dimension, including procedure protocols (bowel prep, polyp search and removal, sedation, infrastructure) and completeness criteria (cecal intubation, procedure duration) that are contributors to adenoma miss rates,2 or lesion yield rates. The scientific rigor in these studies was limited to the follow-up protocol, not in ensuring standardized colonoscopy performance. SN - 0098-7484 M3 - doi: 10.1001/jama.2010.1584 UR - http://dx.doi.org/10.1001/jama.2010.1584 ER -