BACKGROUND: Fecal occult-blood testing and sigmoidoscopy have been recommended for screening for @entity14 , but the sensitivity of such combined testing for detecting @entity5 is uncertain. At 13 Veterans Affairs medical centers, we performed colonoscopy to determine the prevalence of @entity5 and the sensitivity of one-time screening with a fecal occult-blood test plus sigmoidoscopy. METHODS: Asymptomatic subjects (age range, 50 to 75 years) provided stool specimens on cards from three consecutive days for fecal occult-blood testing, which were rehydrated for interpretation. They then underwent colonoscopy. Sigmoidoscopy was defined in this study as examination of the rectum and sigmoid colon during colonoscopy, and sensitivity was estimated by determining how many @entity1 with advanced @entity5 had an @entity652 in the rectum or sigmoid colon. @entity694 was defined as an @entity652 10 mm or more in diameter, a @entity5493 , an @entity652 with high-grade @entity1141 , or @entity3 . Classification of subjects according to the findings was based on the most advanced lesion. RESULTS: A total of 2885 subjects returned the three specimen cards for fecal occult-blood testing and underwent a complete colonoscopic examination. A total of 23.9 percent of subjects with advanced @entity5 had a positive test for fecal occult blood. As compared with subjects who had a negative test for fecal occult blood, the relative risk of advanced @entity5 in subjects who had a positive test was 3.47 (95 percent confidence interval, 2.76 to 4.35). Sigmoidoscopy identified 70.3 percent of all subjects with advanced @entity5 . Combined one-time screening with a fecal occult-blood test and sigmoidoscopy identified 75.8 percent of subjects with advanced @entity5 . CONCLUSIONS: One-time screening with both a fecal occult-blood test with rehydration and sigmoidoscopy fails to detect advanced colonic @entity5 in 24 percent of subjects with the condition.

One-time screening for XXXX with combined fecal occult-blood testing and examination of the distal colon.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5493 :: ('MESH:D018253', 'Disease') :: ['villous adenoma'] @entity5 :: ('MESH:D009369', 'Disease') :: ['neoplasia'] @entity14 :: ('MESH:D015179', 'Disease') :: ['colorectal cancer'] @entity3 :: ('MESH:D009362', 'Disease') :: ['invasive cancer'] @entity652 :: ('MESH:D000236', 'Disease') :: ['adenoma'] @entity694 :: ('MESH:D003110', 'Disease') :: ['Advanced colonic neoplasia'] @entity1141 :: ('MESH:C535662', 'Disease') :: ['dysplasia']
@entity14 :: (MESH:D015179,Disease) :: ['colorectal cancer']
