Is routine screening for colorectal cancer justifiable? This gastroenterologist says NO!
In this era of resource limitations, use of healthcare dollars should be directed to diagnostic and therapeutic programs that can be supported by scientifically valid information. Screening for colorectal cancer has to overcome two limitations before its routine use can be justified. First, the disease is largely a problem in elderly patients, who are likely to have comorbid conditions. Second, any cancer screening identifies mainly slower-growing lesions (i.e., length-time bias), which may be less of a mortal threat in older patients. Data available in 1997 cannot justify implementation of colorectal cancer screening as a public health policy. My advice to individual patients is not to have it done, and we have not instituted the practice at the public hospital where I work. I myself have declined it for each of the past 5 years when my personal physician has offered it to me.
Koretz
R L
RL
Department of Medicine, UCLA Medical Center, Los Angeles 91342, USA.
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002986:Clinical Trials as Topic; D003111:Colonic Polyps / Q000517:prevention & control / Q000601:surgery; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000401:mortality / Q000517:prevention & control*; D003955:Diagnostic Tests, Routine; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D009780:Occult Blood; D011446:Prospective Studies; D012812:Sigmoidoscopy; D014481:United States