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March 27, 1991

Weak Data Mire Colon Screening Debate

JAMA. 1991;265(12):1502-1503. doi:10.1001/jama.1991.03460120016004

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NEW DATA are not quelling the colon cancer screening controversy.

The American Cancer Society is sticking to its advice for fecal occult blood tests to be performed after age 40 and flexible sigmoidoscopy after age 50. This is despite a new Congressional Office of Technology Assessment report. It concludes that screening does not detect enough colon cancer, the second leading cause of cancer death, to justify the cost to Medicare, especially when there is no proof of any impact on mortality (JAMA. 1990;264:2732).

"Looking at exactly the same data, we come up with a different conclusion," says Charles M. Huguley, Jr, MD, a consultant to the American Cancer Society's Medical Affairs Department and professor emeritus at Emory University School of Medicine, Atlanta, Ga.

Screening proponents at recent gastroenterology meetings have presented studies they say show that more intensive follow-up of positive stools with colonoscopy is "mandatory." One analysis says doing