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To the Editor: In their Scientific Review article, Drs Walsh and Terdiman¹ concluded that screening for colorectal cancer is clinically effective. Like other authors,^2-3 they also concluded that the optimal screening method remains uncertain.

On behalf of the New York City Department of Health and Mental Hygiene, we recently established guidelines recommending colonoscopy as the preferred method of screening for colon cancer, with annual fecal occult blood tests (FOBTs) as an acceptable, although not optimal, alternative for patients unable or unwilling to undergo colonoscopy.⁴ Our reasoning was based on the capabilities of colonoscopy to visualize the entire colon and to prevent colon cancer by performing a polypectomy at the time of the screening examination, as well as the large capacity of and the high quality of medical institutions in New York City.

Separately, we surveyed 41 primary care physician opinion leaders (24 internists, 10 family physicians, and 7 obstetrician-gynecology physicians) . . . [Full Text of this Article]

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