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October 12, 1994

Screening for Colorectal Cancer: Which Test Is Best?-Reply

JAMA. 1994;272(14):1100. doi:10.1001/jama.1994.03520140029019

In Reply.  —Dr Mandel and colleagues provide new data from the Minnesota Colon Cancer Control Study and observe correctly that these data could be used to further elucidate the mechanism by which FOBT screening with slide rehydration reduces CRC mortality. We agree that the cumulative rate of colonoscopy in the screened group will have an important effect on any projection of the degree to which random screening colonoscopy, done for workup of false-positive FOBT results, contributes to CRC mortality reductions. The values used in our model were based on the published data.1 We agree that the results also depend on the degree and duration of protective effect from endoscopy screening, so we provided tables showing results for different durations and degrees of protection from endoscopy screening. New insights from the Minnesota study's data might be obtained by considering the types of neoplasms detected in the screened group (ie, early