Magazine article Science News

Colorectal Cancer: To Screen or Not to Screen?

Magazine article Science News

Colorectal Cancer: To Screen or Not to Screen?

Article excerpt

A simple, widely available blood test for colorectal cancer could save nearly 10,000 lives a year in the United States and thousands more worldwide, two new studies show-but only if more people use it.

Although the test is painless, many people find it repugnant because it requires them to supply a fecal sample for lab analysis. Still, doctors say, a little unpleasantness beats risking an untimely, agonizing death.

Colorectal cancer kills 55,000 people in the United States each year. The fecal occult blood test, often ordered by physicians for people over age 50, detects traces of blood shed by malignant bowel tissue. This enables doctors to diagnose and remove some tumors early, boosting a person's odds of sur- vival. Still, because the test detects just one of every four tumors, doctors have questioned whether mass screening would improve overall survival.

Until now, just one controlled trial had addressed the effectiveness of large-scale screening. In that study of 46,551 people, Jack S. Mandel and his colleagues at the University of Minnesota in Minneapolis reported that screen- ing reduces colorectal cancer mortality by one-third. But the study, published in the May 13, 1993 New England Journal of Medicine, had a drawback. The researchers used a highly sensitive test that misses fewer cases of colorectal cancer, but yields more false positives, than the one generally available. Doctors then had to perform the more expensive, more invasive colonoscopy to confirm the presence of cancer.

The new studies, done in Nottingham, England, and Funen, Denmark, assessed the blood test now in common use, the researchers report in the Nov. 30 Lancet.

Jack D. Hardcastle and his colleagues at the University Hospital of Queens Medical Centre in Nottingham tested 44,838 symptomfree men and women age 45 to 74 at least once between 1981 and 1991. …

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