If it works, why not do it?

Article Abstract:

Everyone who is 50 years old or older should have annual screening for fecal blood, which could be a sign of colorectal cancer. The Hemoccult II test is not entirely accurate but could be improved. Three clinical trials have shown that screening for fecal blood can lower the mortality rate from colorectal cancer. The test can produce a false-positive result, but this can be explained to patients at the time they receive the test. The test is cheap, easy to use and only costs $18,000 per year of life saved. This is comparable to many other screening procedures and could be beneficial for a disease that is the second leading cause of death from cancer in the US.

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Postpone population screening until problems are solved

Article Abstract:

It may be premature to recommend screening everyone over the age of 50 for fecal blood every year. Screening is performed by giving patients the Hemoccult II test, which they must return to the physician. But fewer than half do so, and the test is not very accurate in detecting colorectal cancer. It also has a 2% false-positive rate, which may cause much anxiety in people who do not actually have colorectal cancer. The test itself is not expensive, but a positive result means that the person has to undergo colonoscopy or sigmoidoscopy. These procedures are not cheap, and if the test was a false-positive, the expense would be a waste of resources.

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The end of barium enemas?

Article Abstract:

Barium enemas should only be used to detect intestinal polyps if colonoscopy is not available. Intestinal polyps are believed to be a precursor of colorectal cancer. In a study of 480 patients who had both diagnostic procedures, barium enema only detected 39% of the polyps that had been detected by colonoscopy. It was especially poor at detecting small polyps. Some studies have shown that flat areas of the colon can also become cancerous. Diagnostic techniques that look for polyps would miss these types of cancer.

Editorial, Colonoscopy, Intestinal polyps, Barium enema

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