Correspondence that it is therefore eminently possible to tailor screening protocols to suit individual needs.Third, it is stated that individuals with a family history of colorectal cancer have a propensity to develop right-sided lesions. Although this is the case for hereditary non-polyposis colorectal cancer, there is no evidence that it is so for those with a familial tendency.Finally, he points out that it is inappropriate to carry out an incomplete examination on screened patients and thereby perhaps give false reassurance. We would agree with this general sentiment but must point out that he has partly based his viewpoint on a study that found no more pathology in these people than in the general population3. Colonoscopy is an investigation with a morbidity and mortality rate. We believe that the evidence to advocate a 'blanket' policy of colonoscopy for all levels of family risk has not been shown by the currently available data. McConnell JC, Nizen JS, Slade MS. Colonoscopy in patients with a family history of colon cancer. Dis Colon Rectum 1990; 33: McConnell JC. Colonoscopy or flexible proctosigmoidoscopy. Dis Colon Rectum 1990; 33: 722. Grossman S, Milos ML. Colonoscopic screening of persons with suspected risk factors for colorectal cancer. I: Family history. Gastroenterology 1988; 94: 395-400. Herrera L, Hanna S, Petrelli N, Nava H. Screening endoscopy in patients with a family history positive ( F H + ) for colorectal neoplasia (CRN). Gastrointesf Endosc 1990; 36: 211 (Abstract). 105-7. 2.3.
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