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Previous Volume 361:1179-1187 September 17, 2009 Number 12 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.

A healthy 76-year-old woman presents as a new patient for primary care. She reports having one daily bowel movement and no rectal bleeding. She has no family history of colorectal cancer. She reports having negative stool card tests during gynecologic examinations, most recently at 65 years of age. Would you advise this patient to undergo colon-cancer screening, and if so, what test . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Identification of High-Risk Persons

Prevention Strategies for Average-Risk Persons

Screening Tests and Strategies

            Fecal Screening Tests

            Structural Examinations of the Colon

            Radiographic Studies

            Sigmoidoscopy

            Colonoscopy

Risks of Screening

Areas of Uncertainty

Guidelines

Conclusions and Recommendations

Source Information

From the Division of Gastroenterology and Hepatology, Oregon Health and Science University, Portland.

An audio version of this article is available at NEJM.org.

Address reprint requests to Dr. Lieberman at the Department of Medicine, Oregon Health and Science University, Mail Code L461, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97239, or at lieberma@ohsu.edu.

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