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November 7, 1977

Screening for Colorectal Cancer

JAMA. 1977;238(19):2014. doi:10.1001/jama.1977.03280200026003

To the Editor. —  I was disturbed by the letter from Morton Goodman, MD, (237:2380, 1977) because of the methodology used for screening patients for colorectal cancer with Hemoccult slide testing and the conclusions drawn, which I believe to be invalid. Conclusions drawn by Dr Goodman were that the Hemoccult test was an insensitive method for detecting occult blood in the stools of patients in a mass screening setting and, further, that it was of no value in detecting early colorectal cancer in an asymptomatic adult population.The first conclusion regarding sensitivity cannot be addressed by Dr Goodman's study because he has provided no information on the number of patients who have documented blood in the stool by other methods, such as chromium-tagged red cells. Therefore, the test could actually have been extremely sensitive in detecting occult blood in the stools in his group of patients if no other patients