Intended for healthcare professionals


Results of the first round of a demonstration pilot of screening for colorectal cancer in the United Kingdom

BMJ 2004; 329 doi: (Published 15 July 2004) Cite this as: BMJ 2004;329:133

"So do I have cancer, doctor?"

"about half of all colonoscopies carried out on the basis of a
positive test result show no evidence of neoplasia"

As a medical student at Glasgow I was lucky enough to be exposed,
during our colon cancer PBL, to 2 doctors with different views of FOB
screening. Whilst this process will probably save lives, we were also
told that simply brushing your teeth in the morning before the test could
give you a positive result. FOB is clearly NOT a specific test, and I'm
not sure it's really worth it to call hoards of patients back, and
presumably scare them to death in the process, on the grounds that "well,
there might be something wrong with you, maybe", and then proceed to
inflict a colonoscopy in them. The same argument applies to the
sensitivity of the test - do we really want to send 50% of colon cancer
patients home with an ill-founded "all clear"?

I get the feeling that, despite the promising results of this study,
there is still some debate to come on the validity of this screening

Competing interests:
None declared

Competing interests: No competing interests

22 July 2004
Jamie S Robertson
Intercalating Medical Student (Immunology)
University of Glasgow, G12