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September 22, 1997

Colon Cancer ReductionQuestions About Implementation of Proven Techniques

Author Affiliations

Arizona Cancer Center Arizona Health Sciences Center 1501 N Campbell Ave Tucson, AZ 85724 Dr Sampliner is also with the Veterans Affairs Hospital, Tucson.

Arch Intern Med. 1997;157(17):1919-1920. doi:10.1001/archinte.1997.00440380013001

TODAY MEDICINE has at its disposal the means to dramatically reduce both the incidence of and mortality from colorectal cancer1-3; if we make this a health care priority, within 10 years colorectal cancer could be a minor contributor to the total cancer burden.

Although ongoing chemoprevention trials—of diet modification,4 calcium carbonate, folate and nonsteroidal anti-inflammatory drugs (E. R. Greenberg, MD, oral communication, March 23, 1997), wheat bran fiber,5 and ursodeoxycholic acid6—may point the way toward primary preventive strategies, screening at present appears our best weapon against colon cancer. The recent acrimonious debates over the value of mammography hinge largely on the modesty of its effects in lowering mortality from breast cancer: the effects of colorectal cancer screening are not modest.

Our immediate challenge is to organize our screening tools—fecal occult blood testing (FOBT), flexible sigmoidoscopy (FS), and colonoscopy—to lessen the colon cancer burden in the most

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