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Clinical Applications

Judith M. E. Walsh, MD, MPH; Jonathan P. Terdiman, MD

JAMA. 2003;289:1297-1302.

Screening for colorectal cancer reduces mortality in individuals aged 50 years or older. A number of screening tests, including fecal occult blood tests, sigmoidoscopy, double-contrast barium enema, and colonoscopy, are recommended by professional organizations for colorectal cancer screening, yet the rates of colorectal cancer screening remain low. Questions regarding the quality of evidence for each screening test, whether screening for individuals at higher risk should be modified, the availability of the tests, and cost-effectiveness are addressed. Many potential barriers to colorectal cancer screening exist for the patient and the physician. Strategies to increase compliance for colorectal cancer screening are proposed.

Author Affiliations: Division of General Internal Medicine, Departments of Medicine and Epidemiology and Biostatistics (Dr Walsh) and Division of Gastroenterology, Department of Medicine (Dr Terdiman), University of California, San Francisco.

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