Is routine screening for colorectal cancer justifiable? This gastroenterologist says NO!

Abstract:

:In this era of resource limitations, use of healthcare dollars should be directed to diagnostic and therapeutic programs that can be supported by scientifically valid information. Screening for colorectal cancer has to overcome two limitations before its routine use can be justified. First, the disease is largely a problem in elderly patients, who are likely to have comorbid conditions. Second, any cancer screening identifies mainly slower-growing lesions (i.e., length-time bias), which may be less of a mortal threat in older patients. Data available in 1997 cannot justify implementation of colorectal cancer screening as a public health policy. My advice to individual patients is not to have it done, and we have not instituted the practice at the public hospital where I work. I myself have declined it for each of the past 5 years when my personal physician has offered it to me.

journal_name

Postgrad Med

journal_title

Postgraduate medicine

authors

Koretz RL

subject

Has Abstract

pub_date

1997-07-01 00:00:00

pages

49, 53-5, 60-2

issue

1

eissn

0032-5481

issn

1941-9260

journal_volume

102

pub_type

杂志文章
  • Rapid evaluation of comatose patients.

    abstract::Coma is a common, life-threatening medical problem encountered by primary care physicians. The principles of emergency management mandate that adequate oxygenation, blood flow, and supplementation with thiamine and glucose be given to the brain before a thorough diagnostic evaluation is undertaken. Knowledge of the us...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1990.11716346

    authors: Alguire PC

    更新日期:1990-05-01 00:00:00

  • Head trauma in the elderly.

    abstract::Head trauma in the elderly is a major source of morbidity and mortality in this population. Prevention of the primary injury is ideal and requires that the primary care physician understands the neurosensory changes of aging. Failing prevention, rapid diagnosis and efficient management of the traumatized patient are o...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1988.11700292

    authors: Lehman LB

    更新日期:1988-05-15 00:00:00

  • Hyperbaric oxygen therapy. Promoting healing in difficult cases.

    abstract::Inhalation of pressurized 100% oxygen is a helpful adjunctive treatment for certain patients, because the increased oxygen carried by the blood to the tissue enhances new growth of microcirculation and, thus, healing. Patients with tissue breakdown after radiation therapy, refractory osteomyelitis, gas gangrene, soft-...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1986.11699267

    authors: Cohn GH

    更新日期:1986-02-01 00:00:00

  • Liver transplantation. New hope for many patients.

    abstract::Because of the broad range of physiologic problems and the many potential sources of complications, liver transplantation patients require contributions from virtually the complete spectrum of medical science. The evolving specialty of liver transplantation has eagerly assimilated advances in surgical techniques, anes...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.1990.11704566

    authors: Williams JW,Sabesin SM

    更新日期:1990-02-01 00:00:00

  • Drug-induced illness in the elderly.

    abstract::The elderly are predisposed to adverse drug reactions because of age-related physiologic changes, interaction of one drug with another, and interaction between a drug and a coexisting medical condition. Recognition of such adverse reactions is essential, because many are reversible and many are even preventable. Asses...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.1989.11704370

    authors: Harper CM,Newton PA,Walsh JR

    更新日期:1989-08-01 00:00:00

  • Cecal volvulus: A diagnostic and therapeutic challenge.

    abstract::Cecal volvulus is a malrotational abnormality of the intestine that causes obstruction. Diagnosis is difficult and, if delayed, the results may be intestinal ischemia, perforation, sepsis, and even death. Cecal ischemia or gangrene cannot always be determined from physical and laboratory findings. Although not always ...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1982.11716164

    authors: Weiss BD

    更新日期:1982-08-01 00:00:00

  • Health promotion for children. Key to a lifetime of health.

    abstract::Evidence indicates that preventive healthcare in childhood reduces healthcare costs and enhances health. Physicians can assume a leadership role in promoting children's health by incorporating health promotion measures into their everyday practice, serving as resource persons or leaders in community and school efforts...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1987.11699791

    authors: Fletcher DJ,Nelson JH,Nelson NE

    更新日期:1987-04-01 00:00:00

  • The effects of a commercially available weight loss program among obese patients with type 2 diabetes: a randomized study.

    abstract::The purpose of this study was to assess the effects of a commercially available weight loss program on weight and glycemic control among obese patients with type 2 diabetes. Participants included 69 patients (49 females, 20 males) with type 2 diabetes who had a mean +/- SD age of 52.2 +/- 9.5 years, a body mass index ...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.3810/pgm.2009.09.2046

    authors: Foster GD,Borradaile KE,Vander Veur SS,Leh Shantz K,Dilks RJ,Goldbacher EM,Oliver TL,Lagrotte CA,Homko C,Satz W

    更新日期:2009-09-01 00:00:00

  • Decline in the prevalence of pandemic clones Spain23F-1 and Spain9V-3 among US fluoroquinolone-resistant Streptococcus pneumoniae TRUST Surveillance isolates since 2001.

    abstract::Fluoroquinolone-resistant variants of pandemic clones Spain(23F)-1, Spain(6B)-2, Spain(9V)-3, and Spain(14)-5 have been seen in various regions of the United States and the world, leading to the speculation that fluoroquinolone resistance among US Streptococcus pneumoniae may increase because of clonal spread. Using l...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.3810/pgm.2008.09.suppl52.283

    authors: Davies TA,Yee YC,Goldschmidt R,Sahm DF,Evangelista AT

    更新日期:2008-09-01 00:00:00

  • Rheumatoid arthritis. Targeted interventions can minimize joint destruction.

    abstract::Rheumatoid arthritis can cause joint erosion and deformity, pain, stiffness, and decreased function and range of motion. Early diagnosis is crucial to prevent permanent joint damage. In this article, Drs Williams and Fye discuss articular and extra-articular manifestations of rheumatoid arthritis as well as the evolvi...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.3810/pgm.2003.11.1525

    authors: Williams EA,Fye KH

    更新日期:2003-11-01 00:00:00

  • Trekking at high altitudes. How safe is it for your patients?

    abstract::Even healthy persons may experience some form of altitude illness when they hike or ski in high mountains. Therefore, it is imperative that those with compromised cardiac or pulmonary function take extra precautions by allowing time for ascent, by recognizing and accepting their limitations, and by descending promptly...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1990.11716360

    authors: Houston CS

    更新日期:1990-07-01 00:00:00

  • Non-Q wave myocardial infarction. Assessment and management of a unique and diverse subset.

    abstract::Acute cardiac events involving coronary symptoms, elevated enzyme levels, and electrocardiographic changes without the development of Q waves often result in higher rates of reinfarction and unstable angina than do more severe myocardial infarctions. The incidence of these non-Q wave events is on the rise, possibly be...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.3810/pgm.2000.02.890

    authors: Tamberella MR 3rd,Warner JG Jr

    更新日期:2000-02-01 00:00:00

  • Resource use and costs in high-risk symptomatic peripheral artery disease patients with diabetes and prior acute coronary syndrome: a retrospective analysis.

    abstract:OBJECTIVES:As the prevalence of peripheral artery disease (PAD) increases there is growing concern about the associated healthcare burden. This burden has not been well-characterized in high-risk patients with concurrent diabetes and/or acute coronary syndrome (ACS). The objective of this analysis was to assess comorbi...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.2016.1144447

    authors: Reed Chase M,Friedman HS,Navaratnam P,Heithoff K,Simpson RJ Jr

    更新日期:2016-01-01 00:00:00

  • Inflammatory bowel disease. Options in office management.

    abstract::Current therapeutic options make office management of the patient with uncomplicated left-sided ulcerative colitis or mild to moderate Crohn's disease quite feasible for the primary care physician. On the horizon are additional drugs that will enhance the physician's ability to treat patients with inflammatory bowel d...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1988.11700202

    authors: Schuman BM

    更新日期:1988-03-01 00:00:00

  • Atrial flutter. Tracing an elusive arrhythmia.

    abstract::Seven bried case reports representing variations of atrial flutter point up important considerations bearing on diagnosis: situations predisposing individuals to atrial flutter with 1:1 atrioventricular conduction, the need for special care in placing ECG leads for continuous monitoring, the use of carotid sinus massa...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1977.11714577

    authors: Glasser SP,Martinez-Lopez JI

    更新日期:1977-08-01 00:00:00

  • Mechanisms and possible causes of Alzheimer's disease.

    abstract::Alzheimer's disease has been found to be genetically transmitted. Structural changes in the disease include loss of neurons, specifically cholinergic and perhaps noradrenergic neurons. Functional connections among neurons are also lost. No cause has yet been determined, but slow viruses, autoimmune processes, and alum...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1983.11698359

    authors: Schmidt G

    更新日期:1983-04-01 00:00:00

  • Iron deficiency and anemia of chronic disease. Clues to differentiating these conditions.

    abstract::Iron deficiency occurs when the body's iron stores are exhausted. The source of blood loss leading to iron deficiency must be identified in all cases. Anemia of chronic disease generally results from an infectious, inflammatory, or malignant process. However, in some reported cases, no such process could be identified...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.1992.11701469

    authors: Mohler ER Jr

    更新日期:1992-09-15 00:00:00

  • Metabolic aspects of psoriasis: the basis for specific therapy.

    abstract::Psoriasis, like diabetes, is a multifactorial genetic disease with complex interactions of deranged metabolism. Factors that affect epidermal differentiation and proliferation include cyclic nucleotide interactions, polyamine metabolism, cell surface--cytoskeleton interactions, and arachidonic acid--prostaglandin casc...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1980.11715476

    authors: Anderson TF,Voorhees JJ

    更新日期:1980-06-01 00:00:00

  • Diagnosing ascites: the value of abdominal paracentesis.

    abstract::Abdominal paracentesis is a useful and safe technique in the evaluation of ascites. The withdrawn ascitic fluid should be routinely analyzed for appearance, blood cell count, and amylase and total protein concentrations; examined cytologically; and cultured. Results should either substantiate the clinical diagnosis or...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1978.11714844

    authors: Babb RR

    更新日期:1978-05-01 00:00:00

  • Caring for adults with mental disabilities. Problems tend to be complex among this growing population.

    abstract::Providing medical care for patients with mental disabilities may be challenging and financially unappealing because of the need for extra time and effort. Nonetheless, primary care physicians can meet the medical needs of these patients and benefit from working with a team approach that fosters open communication and ...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.3810/pgm.1999.11.776

    authors: Councilman DL

    更新日期:1999-11-01 00:00:00

  • Drug-induced aseptic meningitis. Diagnosis leads to quick resolution.

    abstract::Drug-induced aseptic meningitis is a syndrome that should be considered in the differential diagnosis of acute and recurrent aseptic meningitis. It has been observed in all age-groups and can occur following the use of a wide spectrum of pharmaceutical agents. Presumptive diagnosis is made by demonstrating the resolut...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.1991.11701123

    authors: Chaudhry HJ,Cunha BA

    更新日期:1991-11-15 00:00:00

  • Hyperlipidemia. What is 'normal,' who should be treated and how.

    abstract::Considering that over half of Americans will die from cardiovascular disease, the over-whelming majority of those deaths being from atherosclerosis, we need to accept and act on the vast body of information derived from investigation of coronary risk factors. Identification of persons at risk needs to be done early--w...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1984.11698776

    authors: Glatter TR

    更新日期:1984-11-01 00:00:00

  • Exercise-induced bronchospasm. Achieving control in asthmatic patients.

    abstract::Exercise-induced bronchospasm is a common complication of asthma. Aggressive treatment of this conditions permits patients to maintain full activity despite their illness. Since most asthmatic patients are healthy except for an intermittent respiratory problem, providing them the opportunity to exercise in all weather...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.1992.11701232

    authors: Brook CJ

    更新日期:1992-02-15 00:00:00

  • Comorbidities in patients with irritable bowel syndrome with constipation or chronic idiopathic constipation: a review of the literature from the past decade.

    abstract:BACKGROUND:Irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) are common functional bowel disorders. Patients with IBS-C or CIC often present with ≥ 1 comorbidity that coincides with either of these conditions. These comorbidities may make underappreciated contributions to the ...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.3810/pgm.2013.03.2640

    authors: Nellesen D,Chawla A,Oh DL,Weissman T,Lavins BJ,Murray CW

    更新日期:2013-03-01 00:00:00

  • Gastroesophageal reflux and asthma.

    abstract::Gastroesophageal reflux provokes asthma in many patients. Conversely, asthma predisposes to gastroesophageal reflux. In many patients, reflux therapy will ameliorate asthma. Recognition of this relationship is facilitated by physician awareness, clinical history, selected laboratory tests, and ultimately, a careful mo...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.1989.11704343

    authors: Mansfield LE

    更新日期:1989-07-01 00:00:00

  • No ice, no butter. Advice on management of burns for primary care physicians.

    abstract::It is often difficult to determine the true extent of a burn, but most small thermal burns can be easily evaluated and managed by primary care physicians. In this article, the authors review the characteristics of different types of burns, describe those that require treatment in a burn center, and discuss appropriate...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Clayton MC,Solem LD

    更新日期:1995-05-01 00:00:00

  • Chemotherapy for lung cancer.

    abstract::Oat cell carcinoma is the one variety of primary lung cancer which is sufficiently responsive to a variety of drugs and drug combinations that a very high rate of response and significant prolongation of survival can be consistently achieved. The question of whether anyone has been "cured" by drug treatment awaits mor...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:10.1080/00325481.1978.11714758

    authors: Golbey RB

    更新日期:1978-02-01 00:00:00

  • Concomitant major vessel resection in pancreatic adenocarcinoma.

    abstract::Increasing evidence has contraindicated extended radical dissection of pancreatic adenocarcinoma (PC). With the recent improvement of perioperative management techniques and multimodal treatment strategy for PC, concomitant major vessel resection and reconstruction has thus been aggressively attempted in association w...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:10.1080/00325481.2015.1032180

    authors: Tsuchikawa T,Hirano S,Nakamura T,Okamura K,Tamoto E,Shichinohe T

    更新日期:2015-04-01 00:00:00

  • 'Essential' hypertension with hypokalemia. Caused by aldosterone-secreting adrenal adenoma.

    abstract::Primary aldosteronism is a potentially curable cause of hypertension; it occurs in about 1% of hypertensive patients. In the case reported here, persistent hypokalemia developed in a 72-year-old man who had been treated for 13 years for essential hypertension. Investigation revealed elevated aldosterone level and redu...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章

    doi:

    authors: Burke M,Papo J,Stavorovsky M,Almog C

    更新日期:1984-08-01 00:00:00

  • Thyroid function tests. Guidelines for interpretation in common clinical disorders.

    abstract::While a wide variety of thyroid function tests are currently available, all are sometimes abnormal in patients without thyroid disease. To interpret test results properly, the clinician needs to be aware of factors altering thyroid function tests. In every instance, the clinician needs to begin by asking whether the p...

    journal_title:Postgraduate medicine

    pub_type: 杂志文章,评审

    doi:

    authors: de los Santos ET,Mazzaferri EL

    更新日期:1989-04-01 00:00:00