Does mistrust still linger? A bioethical perspective on colorectal cancer screening

  • Daryl Ramai
  • Denzil Etienne
  • Madhavi Reddy
Letter to the Editor

Dear Editor:

Colorectal cancer (CRC) is the second leading cause of death in both men and women in the USA. Over 135,000 new cases of CRC are expected to occur annually where over 50,000 patients will die of the disease. Screening and prevention of CRC with stool testing or colonoscopy is cost effective and greatly reduces the risk of CRC and death. To this end, the National Colorectal Cancer Roundtable (NCCRT) and CDC’s Heathy People initiative aims to increase the rate of CRC screening to 80% by 2018 and 70% by 2020, respectively. As we approach colon cancer awareness month, I cannot help but ask the question “Are we there yet?”

For patients unwilling to undergo colonoscopy, alternative screening methods are available including the fecal immunochemical test (FIT). FIT delivers CRC screening in the privacy of a patient’s own home without needing to step into a hospital, particularly for individuals who avoid or are fearful of medical institutions. Despite this advantage, CRC screening...


  1. 1.
    Singal AG, Gupta S, Skinner CS, Ahn C, Santini NO, Agrawal D, Mayorga CA, Murphy C, Tiro JA, McCallister K, Sanders JM, Bishop WP, Loewen AC, Halm EA (2017) Effect of colonoscopy outreach vs fecal immunochemical test outreach on colorectal cancer screening completion: a randomized clinical trial. JAMA 318(9):806–815CrossRefPubMedGoogle Scholar
  2. 2.
    Gupta S, Miller S, Koch M, Berry E, Anderson P, Pruitt SL, Borton E, Hughes AE, Carter E, Hernandez S, Pozos H, Halm EA, Gneezy A, Lieberman AJ, Sugg Skinner C, Argenbright K, Balasubramanian B (2016) Financial incentives for promoting colorectal cancer screening: a randomized, comparative effectiveness trial. Am J Gastroenterol 111(11):1630–1636CrossRefPubMedGoogle Scholar
  3. 3.
    Gamble VN (1997) Under the shadow of Tuskegee: African Americans and health care. Am J Public Health 87(11):1773–1778CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Solle NS, Sussman DA, Koru-Sengul T et al (2017) Feasibility of fecal immunochemical testing among Hispanic and Haitian immigrants living in South Florida. JAMA Intern Med 177(3):428–430CrossRefGoogle Scholar
  5. 5.
    Williams R, White P, Nieto J, Vieira D, Francois F, Hamilton F (2016) Colorectal cancer in African Americans: an update. Clin Transl Gastroenterol 7(7):e185CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Christy SM, Davis SN, Williams KR, Zhao X, Govindaraju SK, Quinn GP, Vadaparampil ST, Lin HY, Sutton SK, Roethzeim RR, Shibata D, Meade CD, Gwede CK (2016) A community-based trial of educational interventions with fecal immunochemical test for colorectal cancer screening uptake among blacks in community settings. Cancer 122(21):3288–3296CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Gastroenterology and HepatologyThe Brooklyn Hospital Center, Academic Affiliate of The Icahn School of Medicine at Mount Sinai, Clinical Affiliate of The Mount Sinai HospitalBrooklynUSA

Personalised recommendations