The best screening test for colorectal cancer is the one that gets done well.

摘要

As long as Medicare and insurance companies pay for screening colonoscopies in covered patients, incentives will exist for GI societies to continue to promote colono-scopy as the "best" screening test, though the evidence of its superiority is based solely on observational studies and inferential evidence and despite recent studies that have raised concerns regarding the effectiveness of colonoscopic screening.1"3 The 2008 United States Preventive Services Task Force (USPSTF) Colorectal Cancer (CRC) Screening Guidelines4 do not promote any test as best or claim that , structural examinations are superior to fecal tests. Five multiple-strategy analyses by this organization and the Institute of Medicine did not uniformly find that population screening with colonoscopy was the most effective or cost-effective screening strategy.