PMID: 11916161Mar 28, 2002Paper

Rationale for combining different screening strategies

Gastrointestinal Endoscopy Clinics of North America
Robert H Fletcher

Abstract

It is generally accepted that screening programs should be quite safe, and that the benefits should substantially outweigh the harms. As Cochrane and Holland stated: We believe that there is an ethical difference between everyday medical practice and screening. If a patient asks a medical practitioner for help, the doctor does the best he can. He is not responsible for defects in medical knowledge. If, however, the practitioner initiates screening procedures he is in a very different situation. He should, in our view, have conclusive evidence that screening alters the natural history of disease in a significant proportion of those screened. If this is so, one should recommend the combination over either test alone only if there is sufficient evidence that the combination is more effective and no more dangerous. There is a difference of opinion over whether the evidence, which is certainly not strong, is nevertheless sufficient. This poses a dilemma. Many expert groups prefer that screening for colorectal cancer be done with both FOBT and sigmoidoscopy rather than either alone. Yet, the strength of the evidence for additional effectiveness, and information on the magnitude of that effect if it is present, is substantially less t...Continue Reading

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Citations

Apr 18, 2003·Seminars in Roentgenology·Robert Clark
Mar 11, 2003·Technology in Cancer Research & Treatment·Hugh BarrNicholas Stone
Nov 1, 2006·World Journal of Gastroenterology : WJG·M E de NooL H Bouwman
Mar 30, 2004·The American Journal of Gastroenterology·Francis A FarrayeRobert H Fletcher
Nov 10, 2005·Proceedings·C Richard Boland, Daniel C Demarco
Oct 4, 2017·World Journal of Gastroenterology : WJG·Athanasios HadjipetrouSerafim Kastanakis

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