738 FOBT vs. colonoscopy

One of my Canadian readers (you know who you are) got here because I'd left a comment at his blog when he wrote about the FOBT. Now we regularly visit each other's blogs for topics other than fecal occult blood testing. However, today in the WSJ it was reported that those quicky smear tests done in a doctor's office failed to detect advanced precancerous lesions 95% of the time. That's code for, "they are worthless." Now, the home tests score a little higher. They get it right about 23% of the time. I haven't looked up the article in the Annals of Internal Medicine (one of my favorite journals, btw) to see if that was early or advanced. However, the colonoscopy can actually prevent cancer by finding polyps in the early stage so they can be removed. The sigmoidoscopy is in the middle manager range, but why would you even bother when you can go right to the top--or the bottom, as the case may be.