Randomized trials have shown a consistent 15% to 33% reduction in colorectal cancer mortality through the implementation of annual FOBT (Mandel et al, 1993). In addition, FOBT is certainly the cheapest form of screening available. Although these investigations provide the most concrete evidence favoring screening, the effect of this particular intervention must be considered modest, leading to an examination of its limitations. The low cost of FOBT screening must be weighed against the cost of performing examinations, typically colonoscopy, to follow up positive test results. As noted above, the use of slide rehydration, while improving sensitivity, comes at the cost of a much higher rate of colonoscopy to work
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