This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Oncology  • Colon Cancer  • Surgery  • Surgical Interventions  • Colorectal Surgery  • Diagnosis  • Gastroenterology  • Gastrointestinal Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Schoen and colleagues¹ found that among 9317 individuals who had negative results of a screening sigmoidoscopy, 6 (0.06%) were found to have colorectal cancer by repeated sigmoidoscopy 3 years later. An absolute risk reduction of 0.06% means that 1667 individuals would need to undergo repeat 3-year sigmoidoscopy in order to find 1 case of cancer, assuming none of these cancers would have been discovered by other less invasive methods of screening or by incidental findings.

Sigmoidoscopy is not without risk. Gatto et al² found that the rate of perforation with sigmoidoscopy in Medicare patients to be 0.088%, and that such patients have an increased risk of death (odds ratio, 8.8). Thus, under a policy that recommends repeat sigmoidoscopy at 3-year intervals, patients are at greater risk of having a perforation than of being diagnosed with a new adenocarcinoma.

We also are concerned that this sample may . . . [Full Text of this Article]

Ishay Lev, MD; Amnon Lahad, MD, MPH
Family Medicine Department
Hadassah Medical Center and the Hebrew University

Ariae Ben-Yehuda, MD
Internal Medicine Department
Hadassah Medical Center
Jerusalem, Israel

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Optimal Intervals and Techniques for Screening Sigmoidoscopy
Amnon Sonnenberg and David Lieberman
JAMA. 2003;290(16):2122-2123.
EXTRACT | FULL TEXT  

Optimal Intervals and Techniques for Screening Sigmoidoscopy
Richard C. Wender
JAMA. 2003;290(16):2123.
EXTRACT | FULL TEXT  

Optimal Intervals and Techniques for Screening Sigmoidoscopy—Reply
Robert E. Schoen and Joel L. Weissfeld
JAMA. 2003;290(16):2123.
EXTRACT | FULL TEXT  

Results of Repeat Sigmoidoscopy 3 Years After a Negative Examination
Robert E. Schoen, Paul F. Pinsky, Joel L. Weissfeld, Robert S. Bresalier, Timothy Church, Philip Prorok, and John K. Gohagan
JAMA. 2003;290(1):41-48.
ABSTRACT | FULL TEXT