Improving the Fecal Occult-Blood Test

To the Editor: My colleagues and I reported (Jan. 18 issue) that HemeSelect and a combination test in which HemeSelect is used to confirm positive Hemoccult II Sensa results are an improvement over Hemoccult II in screening patients for colorectal carcinoma. 1 In their accompanying editorial, Ransohoff and Lang 2 limited their endorsement of the combination test, because they misinterpreted our methods and did not recognize that our study was conducted in a setting of routine patient care, not in a clinical-trial setting. Fecal occult-blood testing has been a part of the Kaiser Permanente personal- health appraisal since the late 1970s. We . . .