FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Volume 343:162-168 July 20, 2000 Number 3 Next

	Full Text PDF Editorial by Podolsky, D. K. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article PubMed Citation

ABSTRACT

Background and Methods The role of colonoscopy in screening for colorectal cancer is uncertain. At 13 Veterans Affairs medical centers, we performed colonoscopy to determine the prevalence and location of advanced colonic neoplasms and the risk of advanced proximal neoplasia in asymptomatic patients (age range, 50 to 75 years) with or without distal neoplasia. Advanced colonic neoplasia was defined as an adenoma that was 10 mm or more in diameter, a villous adenoma, an adenoma with high-grade dysplasia, or invasive cancer. In patients with more than one neoplastic lesion, classification was based on the most advanced lesion.

Results Of 17,732 patients screened for enrollment, 3196 were enrolled; 3121 of the enrolled patients (97.7 percent) underwent complete examination of the colon. The mean age of the patients was 62.9 years, and 96.8 percent were men. Colonoscopic examination showed one or more neoplastic lesions in 37.5 percent of the patients, an adenoma with a diameter of at least 10 mm or a villous adenoma in 7.9 percent, an adenoma with high-grade dysplasia in 1.6 percent, and invasive cancer in 1.0 percent. Of the 1765 patients with no polyps in the portion of the colon that was distal to the splenic flexure, 48 (2.7 percent) had advanced proximal neoplasms. Patients with large adenomas (10 mm) or small adenomas (<10 mm) in the distal colon were more likely to have advanced proximal neoplasia than were patients with no distal adenomas (odds ratios, 3.4 [95 percent confidence interval, 1.8 to 6.5] and 2.6 [95 percent confidence interval, 1.7 to 4.1], respectively). However, 52 percent of the 128 patients with advanced proximal neoplasia had no distal adenomas.

Conclusions Colonoscopic screening can detect advanced colonic neoplasms in asymptomatic adults. Many of these neoplasms would not be detected with sigmoidoscopy.

Source Information

From the Veterans Affairs medical centers in Portland, Oreg. (D.A.L.); Perry Point, Md. (D.G.W.); Minneapolis (J.H.B.); Denver (D.J.A.); Tucson, Ariz. (H.G.); and Hines, Ill. (G.C.). Other authors were William V. Harford, M.D., Dallas; Dawn Provenzale, M.D., Durham, N.C.; Steve Sontag, M.D., and Tom Schnell, M.D., Hines, Ill.; Donald R. Campbell, M.D., Kansas City, Mo.; Theodore E. Durbin, M.D., Long Beach, Calif.; Doug B. Nelson, M.D., and Steve L. Ewing, M.D., Minneapolis; George Triadafilopoulos, M.D., Palo Alto, Calif.; Francisco C. Ramirez, M.D., Phoenix, Ariz.; John G. Lee, M.D., Judith F. Collins, M.D., M. Brian Fennerty, M.D., Tiina K. Johnston, Ed.M., and Christopher L. Corless, M.D., Ph.D., Portland, Oreg.; Kenneth R. McQuaid, M.D., San Francisco; Richard E. Sampliner, M.D., Thomas G. Morales, M.D., and Ronnie Fass, M.D., Tucson, Ariz.; and Robert Smith, M.D., and Yogesh Maheshwari, M.D., White River Junction, Vt. — all at Veterans Affairs medical centers.

Address reprint requests to Dr. Lieberman at the Division of Gastroenterology, Oregon Health Sciences University, Portland Veterans Affairs Medical Center, P3-GI, P.O. Box 1034, Portland, OR 97207.

Full Text of this Article

Related Letters:

Screening for Colorectal Cancer
Sherrick R. C., O'Brien K., O'Connell R., O'Connell M., Ault M. J., Mandel S. A., Theuer C. P., Taylor T. H., Anton-Culver H., Lieberman D., Imperiale T. F., Ransohoff D. F., Podolsky D. K.
Extract | Full Text  
N Engl J Med 2000; 343:1651-1654, Nov 30, 2000. Correspondence

This article has been cited by other articles:

• Pickhardt, P. J., Kim, D. H. (2009). Colorectal Cancer Screening With CT Colonography: Key Concepts Regarding Polyp Prevalence, Size, Histology, Morphology, and Natural History. Am. J. Roentgenol. 193: 40-46 [Abstract] [Full Text]  
• Warren, J. L., Klabunde, C. N., Mariotto, A. B., Meekins, A., Topor, M., Brown, M. L., Ransohoff, D. F. (2009). Adverse Events After Outpatient Colonoscopy in the Medicare Population. ANN INTERN MED 150: 849-857 [Abstract] [Full Text]  
• Roy, H. K., Turzhitsky, V., Kim, Y., Goldberg, M. J., Watson, P., Rogers, J. D., Gomes, A. J., Kromine, A., Brand, R. E., Jameel, M., Bogovejic, A., Pradhan, P., Backman, V. (2009). Association between Rectal Optical Signatures and Colonic Neoplasia: Potential Applications for Screening. Cancer Res. 69: 4476-4483 [Abstract] [Full Text]  
• Pickhardt, P. J., Hassan, C., Laghi, A., Kim, D. H. (2009). CT Colonography to Screen for Colorectal Cancer and Aortic Aneurysm in the Medicare Population: Cost-Effectiveness Analysis. Am. J. Roentgenol. 192: 1332-1340 [Abstract] [Full Text]  
• Ashbeck, E. L., Jacobs, E. T., Martinez, M. E., Gerner, E. W., Lance, P., Thompson, P. A. (2009). Components of Metabolic Syndrome and Metachronous Colorectal Neoplasia. Cancer Epidemiol. Biomarkers Prev. 18: 1134-1143 [Abstract] [Full Text]  
• Hassan, C., Pickhardt, P. J., Laghi, A., Zullo, A., Kim, D. H., Iafrate, F., Di Giulio, L., Morini, S. (2009). Impact of Whole-Body CT Screening on the Cost-effectiveness of CT Colonography. Radiology 251: 156-165 [Abstract] [Full Text]  
• Jacobs, E. T., Ahnen, D. J., Ashbeck, E. L., Baron, J. A., Greenberg, E. R., Lance, P., Lieberman, D. A., McKeown-Eyssen, G., Schatzkin, A., Thompson, P. A., Martinez, M. E. (2009). Association Between Body Mass Index and Colorectal Neoplasia at Follow-Up Colonoscopy: A Pooling Study. Am J Epidemiol 169: 657-666 [Abstract] [Full Text]  
• Graser, A, Stieber, P, Nagel, D, Schafer, C, Horst, D, Becker, C R, Nikolaou, K, Lottes, A, Geisbusch, S, Kramer, H, Wagner, A C, Diepolder, H, Schirra, J, Roth, H J, Seidel, D, Goke, B, Reiser, M F, Kolligs, F T (2009). Comparison of CT colonography, colonoscopy, sigmoidoscopy and faecal occult blood tests for the detection of advanced adenoma in an average risk population. Gut 58: 241-248 [Abstract] [Full Text]  
• Wilkins, T., LeClair, B., Smolkin, M., Davies, K., Thomas, A., Taylor, M. L., Strayer, S. (2009). Screening Colonoscopies by Primary Care Physicians: A Meta-Analysis. Ann Fam Med 7: 56-62 [Abstract] [Full Text]  
• Whitlock, E. P., Lin, J. S., Liles, E., Beil, T. L., Fu, R. (2008). Screening for Colorectal Cancer: A Targeted, Updated Systematic Review for the U.S. Preventive Services Task Force. ANN INTERN MED 149: 638-658 [Abstract] [Full Text]  
• Kaltenbach, T, Friedland, S, Soetikno, R (2008). A randomised tandem colonoscopy trial of narrow band imaging versus white light examination to compare neoplasia miss rates. Gut 57: 1406-1412 [Abstract] [Full Text]  
• Lieberman, D. A., Holub, J. L., Moravec, M. D., Eisen, G. M., Peters, D., Morris, C. D. (2008). Prevalence of Colon Polyps Detected by Colonoscopy Screening in Asymptomatic Black and White Patients. JAMA 300: 1417-1422 [Abstract] [Full Text]  
• An, S., Lee, K. H., Kim, Y. H., Park, S. H., Kim, H. Y., Kim, S. H., Kim, N. (2008). Screening CT Colonography in an Asymptomatic Average-Risk Asian Population: A 2-Year Experience in a Single Institution. Am. J. Roentgenol. 191: W100-W106 [Abstract] [Full Text]  
• Sung, J J Y, Lau, J Y W, Young, G P, Sano, Y, Chiu, H M, Byeon, J S, Yeoh, K G, Goh, K L, Sollano, J, Rerknimitr, R, Matsuda, T, Wu, K C, Ng, S, Leung, S Y, Makharia, G, Chong, V H, Ho, K Y, Brooks, D, Lieberman, D A, Chan, F K L, for The Asia Pacific Working Group on Colorectal C, (2008). Asia Pacific consensus recommendations for colorectal cancer screening. Gut 57: 1166-1176 [Abstract] [Full Text]  
• BIANCHI, L. K., BURKE, C. A. (2008). Understanding current guidelines for colorectal cancer screening: A case-based approach. Cleveland Clinic Journal of Medicine 75: 441-448 [Abstract] [Full Text]  
• Levin, B., Lieberman, D. A., McFarland, B., Smith, R. A., Brooks, D., Andrews, K. S., Dash, C., Giardiello, F. M., Glick, S., Levin, T. R., Pickhardt, P., Rex, D. K., Thorson, A., Winawer, S. J., for the American Cancer Society Colorectal Cancer, (2008). Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin 58: 130-160 [Abstract] [Full Text]  
• Hassan, C., Pickhardt, P., Laghi, A., Kim, D., Zullo, A., Iafrate, F., Di Giulio, L., Morini, S. (2008). Computed Tomographic Colonography to Screen for Colorectal Cancer, Extracolonic Cancer, and Aortic Aneurysm: Model Simulation With Cost-effectiveness Analysis. Arch Intern Med 168: 696-705 [Abstract] [Full Text]  
• Rex, D. K., Imperiale, T. F., Regula, J., Polkowski, M., Glaser, D. S., Butterly, L. F., Pohl, H., Kim, D. H., Pickhardt, P. J. (2008). CT Colonography versus Colonoscopy for the Detection of Advanced Neoplasia. NEJM 358: 88-90 [Full Text]  
• Iglar, K., Katyal, S., Matthew, R., Dubey, V. (2008). Complete health checkup for adults: Update on the Preventive Care Checklist Form(C). cfp 54: 84-88 [Full Text]  
• Kim, D. H., Pickhardt, P. J., Taylor, A. J., Leung, W. K., Winter, T. C., Hinshaw, J. L., Gopal, D. V., Reichelderfer, M., Hsu, R. H., Pfau, P. R. (2007). CT Colonography versus Colonoscopy for the Detection of Advanced Neoplasia. NEJM 357: 1403-1412 [Abstract] [Full Text]  
• Knox, L., Hahn, R. G., Lane, C. (2007). A Comparison of Unsedated Colonoscopy and Flexible Sigmoidoscopy in the Family Medicine Setting: An LA Net Study. J Am Board Fam Med 20: 444-450 [Abstract] [Full Text]  
• Kuehle, C. A, Langhorst, J., Ladd, S. C, Zoepf, T., Nuefer, M., Grabellus, F., Barkhausen, J., Gerken, G., Lauenstein, T. C (2007). Magnetic resonance colonography without bowel cleansing: a prospective cross sectional study in a screening population. Gut 56: 1079-1085 [Abstract] [Full Text]  
• O'Dwyer, P. J., Eckhardt, S. G., Haller, D. G., Tepper, J., Ahnen, D., Hamilton, S., Benson, A. B. III, Rothenberg, M., Petrelli, N., Lenz, H.-J., Diasio, R., DuBois, R., Sargent, D., Sloan, J., Johnson, C. D., Comis, R. L., O'Connell, M. J. (2007). Priorities in Colorectal Cancer Research: Recommendations From the Gastrointestinal Scientific Leadership Council of the Coalition of Cancer Cooperative Groups. JCO 25: 2313-2321 [Abstract] [Full Text]  
• Koornstra, J J, Wesseling, J, de Jong, A E, Vasen, H F A, Kleibeuker, J H, Haagsma, E B (2007). Increased risk of colorectal neoplasia in asymptomatic liver-transplant recipients. Gut 56: 892-893 [Full Text]  
• Bach, P. B., Jett, J. R., Pastorino, U., Tockman, M. S., Swensen, S. J., Begg, C. B. (2007). Computed Tomography Screening and Lung Cancer Outcomes. JAMA 297: 953-961 [Abstract] [Full Text]  
• Brenner, H., Chang-Claude, J., Seiler, C. M., Sturmer, T., Hoffmeister, M. (2007). Potential for Colorectal Cancer Prevention of Sigmoidoscopy Versus Colonoscopy: Population-Based Case Control Study. Cancer Epidemiol. Biomarkers Prev. 16: 494-499 [Abstract] [Full Text]  
• Imperiale, T. F. (2007). Quantitative Immunochemical Fecal Occult Blood Tests: Is It Time to Go Back to the Future?. ANN INTERN MED 146: 309-311 [Full Text]  
• Levin, T. R., Zhao, W., Conell, C., Seeff, L. C., Manninen, D. L., Shapiro, J. A., Schulman, J. (2006). Complications of Colonoscopy in an Integrated Health Care Delivery System. ANN INTERN MED 145: 880-886 [Abstract] [Full Text]  
• El-Serag, H. B., Petersen, L., Hampel, H., Richardson, P., Cooper, G. (2006). The use of screening colonoscopy for patients cared for by the department of veterans affairs.. Arch Intern Med 166: 2202-2208 [Abstract] [Full Text]  
• Gross, C. P., McAvay, G. J., Krumholz, H. M., Paltiel, A. D., Bhasin, D., Tinetti, M. E. (2006). The effect of age and chronic illness on life expectancy after a diagnosis of colorectal cancer: implications for screening.. ANN INTERN MED 145: 646-653 [Abstract] [Full Text]  
• Boolchand, V., Olds, G., Singh, J., Singh, P., Chak, A., Cooper, G. S. (2006). Colorectal screening after polypectomy: a national survey study of primary care physicians.. ANN INTERN MED 145: 654-659 [Abstract] [Full Text]  
• Regula, J., Rupinski, M., Kraszewska, E., Polkowski, M., Pachlewski, J., Orlowska, J., Nowacki, M. P., Butruk, E. (2006). Colonoscopy in Colorectal-Cancer Screening for Detection of Advanced Neoplasia. NEJM 355: 1863-1872 [Abstract] [Full Text]  
• (2006). Population screening for colorectal cancer. DTB 44: 65-68 [Abstract] [Full Text]  
• Kung, J. W., Levine, M. S., Glick, S. N., Lakhani, P., Rubesin, S. E., Laufer, I. (2006). Colorectal Cancer: Screening Double-Contrast Barium Enema Examination in Average-Risk Adults Older Than 50 Years. Radiology 240: 725-735 [Abstract] [Full Text]  
• Bini, E. J., Park, J., Francois, F. (2006). Use of Flexible Sigmoidoscopy to Screen for Colorectal Cancer in HIV-Infected Patients 50 Years of Age and Older.. Arch Intern Med 166: 1626-1631 [Abstract] [Full Text]  
• Bleiberg, H., Autier, P., Huet, F., Schrauwen, A. M., Staquet, E., Delaunoit, T., Hendlisz, A., Wyns, C., Panzer, J. M., Caucheteur, B., Eisendrath, P., Grivegnee, A. (2006). Colorectal cancer (CRC) screening using sigmoidoscopy followed by colonoscopy: a feasibility and efficacy study on a cancer institute based population. Ann Oncol 17: 1328-1332 [Abstract] [Full Text]  
• Ferrucci, J. T. (2006). Double-contrast barium enema: use in practice and implications for CT colonography.. Am. J. Roentgenol. 187: 170-173 [Abstract] [Full Text]  
• Singh, H., Turner, D., Xue, L., Targownik, L. E., Bernstein, C. N. (2006). Risk of developing colorectal cancer following a negative colonoscopy examination: evidence for a 10-year interval between colonoscopies.. JAMA 295: 2366-2373 [Abstract] [Full Text]  
• Winawer, S. J., Zauber, A. G., Fletcher, R. H., Stillman, J. S., O'Brien, M. J., Levin, B., Smith, R. A., Lieberman, D. A., Burt, R. W., Levin, T. R., Bond, J. H., Brooks, D., Byers, T., Hyman, N., Kirk, L., Thorson, A., Simmang, C., Johnson, D., Rex, D. K. (2006). Guidelines for Colonoscopy Surveillance after Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society.. CA Cancer J Clin 56: 143-159 [Abstract] [Full Text]  
• Rex, D. K., Kahi, C. J., Levin, B., Smith, R. A., Bond, J. H., Brooks, D., Burt, R. W., Byers, T., Fletcher, R. H., Hyman, N., Johnson, D., Kirk, L., Lieberman, D. A., Levin, T. R., O'Brien, M. J., Simmang, C., Thorson, A. G., Winawer, S. J. (2006). Guidelines for Colonoscopy Surveillance after Cancer Resection: A Consensus Update by the American Cancer Society and US Multi-Society Task Force on Colorectal Cancer.. CA Cancer J Clin 56: 160-167 [Abstract] [Full Text]  
• Thompson, W. M., Foster, W. L., Paulson, E. K., Niedzwiecki, D., Low, V. H. S., Fulford, L. B., Broomer, B. W., Sanders, L., Rockey, D. C. (2006). Causes of Errors in Polyp Detection at Air-Contrast Barium Enema Examination. Radiology 239: 139-148 [Abstract] [Full Text]  
• Taylor, S A, Halligan, S, Slater, A, Burling, D, Marshall, M, I Bartram, C (2006). Comparison of Radiologists' confidence in excluding significant colorectal neoplasia with multidetector-row CT colonography compared with double contrast barium enema.. Br. J. Radiol. 79: 208-214 [Abstract] [Full Text]  
• Roy, H. K., Kim, Y. L., Liu, Y., Wali, R. K., Goldberg, M. J., Turzhitsky, V., Horwitz, J., Backman, V. (2006). Risk Stratification of Colon Carcinogenesis through Enhanced Backscattering Spectroscopy Analysis of the Uninvolved Colonic Mucosa. Clin. Cancer Res. 12: 961-968 [Abstract] [Full Text]  
• Iannaccone, R., Catalano, C., Mangiapane, F., Murakami, T., Lamazza, A., Fiori, E., Schillaci, A., Marin, D., Nofroni, I., Hori, M., Passariello, R. (2005). Colorectal Polyps: Detection with Low-Dose Multi-Detector Row Helical CT Colonography versus Two Sequential Colonoscopies. Radiology 237: 927-937 [Abstract] [Full Text]  
• Macari, M., Bini, E. J. (2005). CT Colonography: Where Have We Been and Where Are We Going?. Radiology 237: 819-833 [Abstract] [Full Text]  
• Olson, R. P., Stone, A., Lubarsky, D. (2005). The Prevalence and Significance of Low Preoperative Hemoglobin in ASA 1 or 2 Outpatient Surgery Candidates. Anesth. Analg. 101: 1337-1340 [Abstract] [Full Text]  
• Klabunde, C., Breen, N., Meissner, H., Subramanian, S. (2005). Use of Colonoscopy for Colorectal Cancer Screening. Cancer Epidemiol. Biomarkers Prev. 14: 2279-2280 [Full Text]  
• Levin, T. R., Atkin, W. S., Thomas, C. M., Schoenfeld, P., Lieberman, D. (2005). Colonoscopic Screening of Women for Colorectal Neoplasia. NEJM 353: 844-846 [Full Text]  
• Eisen, G. M., Weinberg, D. S. (2005). Narrative Review: Screening for Colorectal Cancer in Patients with a First-Degree Relative with Colonic Neoplasia. ANN INTERN MED 143: 190-198 [Abstract] [Full Text]  
• Gutman, F., Alberini, J.-L., Wartski, M., Vilain, D., Le Stanc, E., Sarandi, F., Corone, C., Tainturier, C., Pecking, A. P. (2005). Incidental Colonic Focal Lesions Detected by FDG PET/CT. Am. J. Roentgenol. 185: 495-500 [Abstract] [Full Text]  
• Levin, T R, Farraye, F A, Schoen, R E, Hoff, G, Atkin, W, Bond, J H, Winawer, S, Burt, R W, Johnson, D A, Kirk, L M, Litin, S C, Rex, D K (2005). Quality in the technical performance of screening flexible sigmoidoscopy: recommendations of an international multi-society task group. Gut 54: 807-813 [Abstract] [Full Text]  
• Schoenfeld, P., Cash, B., Flood, A., Dobhan, R., Eastone, J., Coyle, W., Kikendall, J. W., Kim, H. M., Weiss, D. G., Emory, T., Schatzkin, A., Lieberman, D., the CONCeRN Study Investigators, (2005). Colonoscopic Screening of Average-Risk Women for Colorectal Neoplasia. NEJM 352: 2061-2068 [Abstract] [Full Text]  
• Lin, O. S., Gerson, L. B., Soon, M.-S., Schembre, D. B., Kozarek, R. A. (2005). Risk of Proximal Colon Neoplasia With Distal Hyperplastic Polyps: A Meta-analysis. Arch Intern Med 165: 382-390 [Abstract] [Full Text]  
• Subramanian, S., Amonkar, M. M., Hunt, T. L. (2005). Use of Colonoscopy for Colorectal Cancer Screening: Evidence from the 2000 National Health Interview Survey. Cancer Epidemiol. Biomarkers Prev. 14: 409-416 [Abstract] [Full Text]  
• Collins, J. F., Lieberman, D. A., Durbin, T. E., Weiss, D. G., and the Veterans Affairs Cooperative Study #380 Gr, (2005). Accuracy of Screening for Fecal Occult Blood on a Single Stool Sample Obtained by Digital Rectal Examination: A Comparison with Recommended Sampling Practice. ANN INTERN MED 142: 81-85 [Abstract] [Full Text]  
• Hawk, E. T., Levin, B. (2005). Colorectal Cancer Prevention. JCO 23: 378-391 [Abstract] [Full Text]  
• Kapoor, N, Bassi, A, Sturgess, R, Bodger, K (2005). Predictive value of alarm features in a rapid access upper gastrointestinal cancer service. Gut 54: 40-45 [Abstract] [Full Text]  
• Terzolo, M., Reimondo, G., Gasperi, M., Cozzi, R., Pivonello, R., Vitale, G., Scillitani, A., Attanasio, R., Cecconi, E., Daffara, F., Gaia, E., Martino, E., Lombardi, G., Angeli, A., Colao, A. (2005). Colonoscopic Screening and Follow-Up in Patients with Acromegaly: A Multicenter Study in Italy. J. Clin. Endocrinol. Metab. 90: 84-90 [Abstract] [Full Text]  
• Xiong, T, Richardson, M, Woodroffe, R, Halligan, S, Morton, D, Lilford, R J (2005). Incidental lesions found on CT colonography: their nature and frequency. Br. J. Radiol. 78: 22-29 [Abstract] [Full Text]  
• Imperiale, T. F., Ransohoff, D. F., Itzkowitz, S. H., Turnbull, B. A., Ross, M. E., the Colorectal Cancer Study Group, (2004). Fecal DNA versus Fecal Occult Blood for Colorectal-Cancer Screening in an Average-Risk Population. NEJM 351: 2704-2714 [Abstract] [Full Text]  
• Fearnhead, N. S., Wilding, J. L., Winney, B., Tonks, S., Bartlett, S., Bicknell, D. C., Tomlinson, I. P. M., Mortensen, N. J. McC., Bodmer, W. F. (2004). Multiple rare variants in different genes account for multifactorial inherited susceptibility to colorectal adenomas. Proc. Natl. Acad. Sci. USA 101: 15992-15997 [Abstract] [Full Text]  
• Zapka, J. G., Lemon, S. C., Puleo, E., Estabrook, B., Luckmann, R., Erban, S. (2004). Patient Education for Colon Cancer Screening: A Randomized Trial of a Video Mailed before a Physical Examination. ANN INTERN MED 141: 683-692 [Abstract] [Full Text]  
• Battat, A. C., Rouse, R. V., Dempsey, L., Safadi, B. Y., Wren, S. M. (2004). Institutional Commitment to Rectal Cancer Screening Results in Earlier-Stage Cancers on Diagnosis. Ann. Surg. Oncol. 11: 970-976 [Abstract] [Full Text]  
• Kamel, E. M., Thumshirn, M., Truninger, K., Schiesser, M., Fried, M., Padberg, B., Schneiter, D., Stoeckli, S. J., von Schulthess, G. K., Stumpe, K. D.M. (2004). Significance of Incidental 18F-FDG Accumulations in the Gastrointestinal Tract in PET/CT: Correlation with Endoscopic and Histopathologic Results. JNM 45: 1804-1810 [Abstract] [Full Text]  
• Chao, A., Connell, C. J., Cokkinides, V., Jacobs, E. J., Calle, E. E., Thun, M. J. (2004). Underuse of Screening Sigmoidoscopy and Colonoscopy in a Large Cohort of US Adults. Am. J. Public Health 94: 1775-1781 [Abstract] [Full Text]  
• Hoff, G, Grotmol, T, Thiis-Evensen, E, Bretthauer, M, Gondal, G, Vatn, M H (2004). Testing for faecal calprotectin (PhiCal) in the Norwegian Colorectal Cancer Prevention trial on flexible sigmoidoscopy screening: comparison with an immunochemical test for occult blood (FlexSure OBT). Gut 53: 1329-1333 [Abstract] [Full Text]  
• Pickhardt, P. J., Choi, J. R., Hwang, I., Schindler, W. R. (2004). Nonadenomatous Polyps at CT Colonography: Prevalence, Size Distribution, and Detection Rates. Radiology 232: 784-790 [Abstract] [Full Text]  
• Mysliwiec, P. A., Brown, M. L., Klabunde, C. N., Ransohoff, D. F. (2004). Are Physicians Doing Too Much Colonoscopy? A National Survey of Colorectal Surveillance after Polypectomy. ANN INTERN MED 141: 264-271 [Abstract] [Full Text]  
• Cotton, P. B., Durkalski, V. L., Pineau, B. C., Palesch, Y. Y., Mauldin, P. D., Hoffman, B., Vining, D. J., Small, W. C., Affronti, J., Rex, D., Kopecky, K. K., Ackerman, S., Burdick, J. S., Brewington, C., Turner, M. A., Zfass, A., Wright, A. R., Iyer, R. B., Lynch, P., Sivak, M. V., Butler, H. (2004). Computed Tomographic Colonography (Virtual Colonoscopy): A Multicenter Comparison With Standard Colonoscopy for Detection of Colorectal Neoplasia. JAMA 291: 1713-1719 [Abstract] [Full Text]  
• Ransohoff, D. F. (2004). Virtual Colonoscopy--What It Can Do vs What It Will Do. JAMA 291: 1772-1774 [Full Text]  
• Yamaji, Y, Mitsushima, T, Ikuma, H, Watabe, H, Okamoto, M, Kawabe, T, Wada, R, Doi, H, Omata, M (2004). Incidence and recurrence rates of colorectal adenomas estimated by annually repeated colonoscopies on asymptomatic Japanese. Gut 53: 568-572 [Abstract] [Full Text]  
• Takahashi, P. Y., Okhravi, H. R., Lim, L. S., Kasten, M. J. (2004). Preventive Health Care in the Elderly Population: A Guide for Practicing Physicians. Mayo Clin Proc. 79: 416-427 [Abstract]  
• Macari, M., Bini, E. J., Jacobs, S. L., Naik, S., Lui, Y. W., Milano, A., Rajapaksa, R., Megibow, A. J., Babb, J. (2004). Colorectal Polyps and Cancers in Asymptomatic Average-Risk Patients: Evaluation with CT Colonography. Radiology 230: 629-636 [Abstract] [Full Text]  
• Colao, A., Ferone, D., Marzullo, P., Lombardi, G. (2004). Systemic Complications of Acromegaly: Epidemiology, Pathogenesis, and Management. Endocr. Rev. 25: 102-152 [Abstract] [Full Text]  
• Palmer, K, Morris, A I (2004). A snapshot of colonoscopy practice in England: stimulus for improvement. Gut 53: 163-165 [Full Text]  
• Imperiale, T. F., Wagner, D. R., Lin, C. Y., Larkin, G. N., Rogge, J. D., Ransohoff, D. F. (2003). Using Risk for Advanced Proximal Colonic Neoplasia To Tailor Endoscopic Screening for Colorectal Cancer. ANN INTERN MED 139: 959-965 [Abstract] [Full Text]  
• Lieberman, D. A., Prindiville, S., Weiss, D. G., Willett, W. (2003). Risk Factors for Advanced Colonic Neoplasia and Hyperplastic Polyps in Asymptomatic Individuals. JAMA 290: 2959-2967 [Abstract] [Full Text]  
• Pickhardt, P. J., Choi, J. R., Hwang, I., Butler, J. A., Puckett, M. L., Hildebrandt, H. A., Wong, R. K., Nugent, P. A., Mysliwiec, P. A., Schindler, W. R. (2003). Computed Tomographic Virtual Colonoscopy to Screen for Colorectal Neoplasia in Asymptomatic Adults. NEJM 349: 2191-2200 [Abstract] [Full Text]  
• Herfarth, H, Schreyer, A G (2003). The virtuosity of virtuality or how real is virtual colonography. Gut 52: 1662-1664 [Full Text]  
• Ramakrishnan, K., Scheid, D. C. (2003). Predictors of Incomplete Flexible Sigmoidoscopy. J Am Board Fam Med 16: 478-484 [Abstract] [Full Text]  
• Sonnenberg, A., Lieberman, D. (2003). Optimal Intervals and Techniques for Screening Sigmoidoscopy. JAMA 290: 2122-2123 [Full Text]  
• Winawer, S. J (2003). New colorectal cancer screening guidelines. BMJ 327: E196-197 [Full Text]  
• Schoen, R. E. (2003). Prevalence of Isolated Advanced Proximal Neoplasia. Arch Intern Med 163: 2103-2103 [Full Text]  
• Ferrucci, J. T. (2003). Virtual Colonoscopy for Colon Cancer Screening: Further Reflections on Polyps and Politics. Am. J. Roentgenol. 181: 795-797 [Full Text]  
• Vos, F. M., van Gelder, R. E., Serlie, I. W. O., Florie, J., Nio, C. Y., Glas, A. S., Post, F. H., Truyen, R., Gerritsen, F. A., Stoker, J. (2003). Three-dimensional Display Modes for CT Colonography: Conventional 3D Virtual Colonoscopy versus Unfolded Cube Projection. Radiology 228: 878-885 [Abstract] [Full Text]  
• Chan, T. L., Zhao, W., Cancer Genome Project, , Leung, S. Y., Yuen, S. T. (2003). BRAF and KRAS Mutations in Colorectal Hyperplastic Polyps and Serrated Adenomas. Cancer Res. 63: 4878-4881 [Abstract] [Full Text]