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JNCI Journal of the National Cancer Institute 1999 91(19):1602-1603; doi:10.1093/jnci/91.19.1602
© 1999 by Oxford University Press
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Journal of the National Cancer Institute, Vol. 91, No. 19, 1602-1603, October 6, 1999
© 1999 Oxford University Press

EDITORIALS

Improving the Effectiveness of Fecal Occult Blood Screening for Colorectal Cancer

John H. Bond

Affiliations of author: Gastroenterology Section, Minneapolis Department of Veterans Affairs Medical Center, and University of Minnesota, Minneapolis.

Correspondence to: John H. Bond, M.D., Gastroenterology Section (111D), VA Medical Center, One Veterans Dr., Minneapolis, MN 55417.

The Medicare claims analysis by Lurie and Welch (1) in this issue of the Journal suggests that only a minority of patients have an appropriate diagnostic work-up after a positive screening fecal occult blood test (FOBT). Their analysis requires several unproven assumptions and, therefore, may reflect only an approximation of actual clinical practice. Nevertheless, the magnitude of the deviation from colorectal cancer screening guideline recommendations identifies a problem that must be addressed if FOBT screening is to be both effective and cost-effective.

Some, but not all, of the limitations of this database analysis are addressed by the authors. Lurie and Welch (1) acknowledge that 1) they do not know if the FOBTs identified in 1995 were performed for screening, 2) they do not . . . [Full Text of this Article]

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