| [ Summary ] |
Screening with FOB testing has been shown to be effective in reducing colorectal cancer mortality rates. There are several problems with diagnostic procedures in the colorectal screening program in terms of mortality reduction in our community. First, compliance rates need to be high for diagnostic exaimnations. However, only 60% of those requiring diagnostic follow-ups comply with these procedures. Second, sigmoidoscopy in combination with double contrast barium enemas, which are frequently performed as part of diagnostic examinations, are reportedly much less sensitive than colonoscopies. This is particularly so in detecting cancer in the proximal colon. Colonoscopy should be primarily performed as a diagnostic test.
In addition, annual screening rounds find subjects who repeatedly test positive. Whether colonoscopy is necessary for such patients remains to be seen. The issues related to diagnostic follow-ups are discussed. |