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October 12, 1994

Screening for Colorectal Cancer: Which Test Is Best?

Author Affiliations

New Brunswick, NJ

JAMA. 1994;272(14):1099-1100. doi:10.1001/jama.1994.03520140029017

To the Editor.  —The article by Drs Lang and Ransohoff1 does not take issue with the evidence that FOBT screening reduces mortality. The authors feel that the reduction in mortality may be attributable to chance selection for colonoscopy. They conclude their article stating that annual FOBT with rehydration of slides should not be advocated at the present time. I would think that one could reach the opposite conclusion from their data and conclude that rehydration should be done with enthusiasm. How else am I to bring a patient to a potentially lifesaving colonoscopy?If a hypothetical patient sees me, appears to be in the colon cancer age group, and is highly motivated to prevent colon cancer, it does not seem acceptable to simply schedule him or her for a colonoscopy. There are no published guidelines that would support one in that action. In fact, in the recommendations of the

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