The July 1 Health Journal article "Getting Screened for Colon Cancer Isn't Just for the 50-and-Over Set" by Tara Parker-Pope was important. Colorectal cancer is both a major cancer killer and largely preventable with appropriate screening. Deciding who should and should not be screened is crucial, as it would be prohibitively expensive to screen everyone over age 40, instead of the currently recommended age cut-off of 50.
Ms. Parker-Pope describes several risk factors that should prompt consideration for earlier screening, but she left out two important risk groups: those with active and extensive inflammatory bowel disease (ulcerative colitis in particular) and smokers. In recent years, smoking has been identified as a significant risk factor for colorectal cancer, among many other cancers so linked. But because it takes many years for the increased risk to manifest in polyps and cancer, this risk factor was only recently identified, after the results of several long-term studies were published.
Gilbert Ross, M.D.
Medical/Executive Director
American Council on Science and Health
New York
