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To the Editor: Drs Walsh and Terdiman^1-2 reviewed the evidence on the efficacy of various screening tests for the prevention of colorectal cancer. Although the authors provided an extensive discussion of guiac-based FOBTs, they did not mention fecal immunochemical tests. However, a recent statement by the American Cancer Society's Colorectal Cancer Advisory Group supports the use of such tests.³ Similarly, a recent statement by the American Cancer Society concludes that "in comparison with guaiac-based tests for the detection of occult blood, immunochemical tests are more patient-friendly, and are likely to be equal or better in sensitivity and specificity."⁴

Immunochemical tests are specific for lower gastrointestinal tract bleeding,⁵ are not affected by diet or medications, engender greater patient participation, and provide a stable end point that can be read precisely.

AUTHOR INFORMATION
Financial Disclosure: Dr Schlackman is an employee of Enterix Inc, which manufactures immunochemical FOBTs.

Neil Schlackman, MD
Enterix Inc
Falmouth, Me

1. Walsh JME, Terdiman JP. Colorectal cancer screening: scientific review. JAMA. 2003;289:1288-1296. FREE FULL TEXT 2. Walsh JME, Terdiman JP. Colorectal cancer screening: clinical applications. JAMA. 2003;289:1297-1302. FREE FULL TEXT 3. Levin B, Brooks D, Smith RA, Stone A. Emerging technologies in screening for colorectal cancer. CA Cancer J Clin. 2003;53:44-55. FREE FULL TEXT 4. Smith RA, Cokkinides V, Eyre HJ. American Cancer Society guidelines for the early detection of cancer, 2003. CA Cancer J Clin. 2003;53:27. FREE FULL TEXT 5. Rockey DC, Auslander A, Greenberg PD. Detection of upper gastrointestinal blood with fecal occult blood tests. Am J Gastroenterol. 1999;94:344-350. FULL TEXT | ISI | PUBMED

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290:191.

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