CA: A Cancer Journal for Clinicians, Vol 27, 338-343, Copyright
© 1977 by American Cancer Society
Colorectal Cancer: Are the Goals of Early Detection Achieved?
Sidney F. Miller M.D.1
1 Associate Director of Education, Department of Surgery, Miami Valley Hospital, Dayton, Ohio, and Assistant Clinical Professor of Surgery, Wright State University School of Medicine, Dayton, Ohio.
A review of the American Cancer Society's statistics for the surgery of colorectal cancer indicates that little or no improvement has been made in the survival rate in the last ten years. Improved surgical techniques, radiation therapy and chemotherapy are of little benefit if the patient has regional or distal metastasis at the time of his initial diagnosis. Proctosigmoidoscopy and stool testing for occult blood have both detected new cases of colorectal cancer and patients at an earlier stage in their disease. The Hemoccult test, however, is less expensive, can be used on a routine basis, is easier for patients to perform and is esthetically pleasing to both patients and personnel. It represents a significant cost savings compared with proctosigmoidoscopy and should be used routinely on all patients over 40 years of age. As suggested by doubling times for colorectal cancer, it appears that the examination should be repeated at least biannually.
The value of Hemoccult testing in the diagnosis of early colorectal cancer has been proven, and this review indicates its value in not only detecting carcinoma but also detecting it at an earlier, and hopefully curable stage. Recently the American Cancer Society has endosed Hemoccults as a form of early cancer detection, and it seems reasonable now that Hemoccult testing should become part of routine office practice. Although there continues to be a role for local and regional mass screening programs, either on a county-wide or industrial basis, significant improvement in colorectal cancer survival rates cannot be expected until routine application of this type of screening is practiced.
