Detailed Screening for Colorectal Cancer by Sequential Use of Colonoscopy and Barium Enema

The authors analysed colorectal cancers, especially of early cancers detected during 5-year period from 1978 when colonoscopy was begun and evaluated the results of screening. Four hundred and four colorectal cancers including 121 early cancers were detected during the 5-year period from 1978 to 1982. A rate of early cancer among total patients increased from 0.6 % in 1978 to 1.1 % in 1982. A rate of early to total cancers increased from 12 % in 1978 to 37 % in 1982. During the period, total colonoscopy was done more and more extensively from a selected use in cases with suspicious barium enema to a detailed screening colonoscopy for high-risk individuals. Therefore, the detection rate of early colorectal cancer was raised from 0.2 % to 0.9 % of total examinations (barium enema combined with colonoscopy). The sequentiol use of barium enema following total colonoscopy is most effective as detailed screening for colorectal cancer.