One-Time Screening for Colorectal Cancer with Combined Fecal Occult-Blood Testing and Examination of the Distal Colon

• Published in: The New England journal of medicine Vol. 345; no. 8; pp. 555 - 560
• Main Authors: Lieberman, David A, Harford, William V, Ahnen, Dennis J, Provenzale, Dawn, Sontag, Stephen J, Schnell, Thomas G, Chejfec, Gregorio, Campbell, Donald R, Durbin, Theodore E, Bond, John H, Nelson, Douglas B, Ewing, Stephen L, Triadafilopoulos, George, Ramirez, Francisco C, Lee, John G, Collins, Judith F, Fennerty, M. Brian, Johnston, Tiina K, Corless, Christopher L, McQuaid, Kenneth R, Garewal, Harinder, Sampliner, Richard E, Morales, Thomas G, Fass, Ronnie, Smith, Robert E, Maheshwari, Yogesh, Weiss, David G
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 23.08.2001
• Subjects: Adenoma - diagnosis; Adenoma - pathology; Aged; Biological and medical sciences; Colon; Colonic Neoplasms - diagnosis; Colonic Neoplasms - pathology; Colonic Polyps - diagnosis; Colonoscopy; Colorectal cancer; Colorectal Neoplasms - diagnosis; Diagnostic Errors; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Male; Mass Screening - methods; Medical sciences; Middle Aged; Mortality; Neoplasm Invasiveness; Occult Blood; Predictive Value of Tests; Sensitivity and Specificity; Sigmoidoscopy; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors; Palo Alto California; United States > US; Human; Rectal disease; Sigmoidoscopy; Exploration; Malignant tumor; Medical screening; Blood; Colonic disease; Rectum; Digestive diseases; Intestinal disease; Endoscopy; Colon; Feces
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa010328

Occult-blood testing and sigmoidoscopy fails to identify about 25 percent of patients with colonic neoplasia. Screening of populations who are over 50 years of age, have no symptoms of colorectal cancer, and are at average risk for the disease has been advocated by many organizations and expert panels. 1 – 5 There is evidence that screening persons who have no symptoms with the use of a fecal occult-blood test or sigmoidoscopy can reduce mortality from colorectal cancer. 6 – 10 Several expert panels 2 – 5 have recommended combined screening with sigmoidoscopy and a fecal occult-blood test. Proponents of combined screening argue that advanced neoplasia could be detected in more patients by combined screening than by one test. However, few studies . . .