Gastroenterology
Volume 139, Issue 3 , Page 1065, September 2010

Colorectal Cancer Screening: From Perspectives to Reality

published online 23 July 2010.

Article Outline

 

Dear Sir:

Gellad and Provenzale1 offered a perfect summary of the public health perspectives for colorectal cancer: Frequency, severity, effectiveness of screening with disparities, not only nationally but also worldwide. However, the 54% participation rate reported for screening in France (see Table 4) is not accurate. Official calls for screening were published as early as 1995 (the results of the two 1996 Lancet papers being available since 1994).2 However, screening was only implemented in 2003, in only 23 departments out of 100: The mean participation rate for the first intervention was 42%, 5 over 50% (the best was 54%) and 5 below 35%.3 For the second intervention, generalization to all 100 departments occurred in late 2008; Denis et al4 recently reported a decreased in participation rate.

Gellad and Provenzale1 rightly underlined the variability of screening strategies and stated it remains a matter of debate. Debate may not be the right term: For themselves, gastroenterologists rely on colonoscopy not on fecal occult blood tests; President Obama, at age 49, relies on a virtual colonoscopy. Accordingly, I cannot share the conclusion stating there is room for hope, because I can hardly see a cubicle for ethics.

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References 

  1. Gellad ZF, Provenzale D. Colorectal cancer: national and international perspective on the burden of disease and public health Impact. Gastroenterology. 2010;138:2177–2190
  2. Dubois G. Screening for colorectal cancer (French Working Group on Colorectal Cancer Screening). N Engl J Med. 1995;333:460–461
  3. Braillon A, Dubois G. French health policy and screening for colorectal cancer. Gastroenterol Clin Biol. 2010;34:142–143
  4. Denis B, Gendre I, Ebelin JF, et al. Do the results of the organized screening for the colorectal cancer by Hémoccult remain stable?. Gastroenterol Clin Biol. 2009;33:16

 Conflicts of interest The author discloses no conflicts.

PII: S0016-5085(10)01042-5

doi:10.1053/j.gastro.2010.06.073

Refers to article:

  • Colorectal Cancer: National and International Perspective on the Burden of Disease and Public Health Impact

    Ziad F. Gellad, Dawn Provenzale
    Gastroenterology May 2010 (Vol. 138, Issue 6, Pages 2177-2190)

Gastroenterology
Volume 139, Issue 3 , Page 1065, September 2010

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