[Skip to Navigation]
Views 378
Citations 0
Comment & Response
January 2017

Colorectal Cancer Screening Comparative Effectiveness—Clinical Trials Are Not Always the Answer

Author Affiliations
  • 1University of Pennsylvania Perelman School of Medicine, Department of Family Medicine and Community Health, Philadelphia
JAMA Intern Med. 2017;177(1):143-144. doi:10.1001/jamainternmed.2016.7831

To the Editor There is a paucity of strong empirical evidence to inform crucial policy decisions on the comparative screening effectiveness of colorectal cancer tests, as Dr Redberg noted in an Editorial in a recent issue of JAMA Internal Medicine.1 However, more randomized clinical trials (RCT) may not be the answer to this scientific conundrum, although there is reasonable equipoise for a study colonoscopy vs sigmoidoscopy plus high-sensitivity guaiac or immunochemical fecal occult blood test (FOBT). Unfortunately, non-US studies may not adequately capture the experience of many American clinicians and patients, and current US RCTs may be underpowered to provide answers about effectiveness in the entire colon.

Add or change institution