Kevin Schulman, MD
To the Editors: Understanding the sensitivity and specificity of Hemoccult cards is instrumental in developing recommendations for the screening of patients for detection of colon cancer. The recent study by Allison and colleagues (1) addresses these issues, but has several serious flaws.
The investigators relied on a "work-up" of Hemoccult-positive cases to determine true-positive and false-positive cases. The "work-up," however, consisted of sending physicians caring for these patients a letter recommending "a complete gastrointestinal evaluation." The letter recommended several different test modalities alone or in combination. The investigators do not report how many patients actually received a "complete evaluation," nor
Schulman K. Screening for Colorectal Cancer. Ann Intern Med. ;113:333. doi: 10.7326/0003-4819-113-4-333_1
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Published: Ann Intern Med. 1990;113(4):333.
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