Hemoccult screening for colorectal carcinoma was begun in 1979 at the Kaiser Permanente Medical Center, Oakland, California, as part of a program for periodic health examinations. A concomitant cost-benefit analysis was conducted to determine the long-term medical care costs and survival benefits of this procedure. Of 14,041 patients ≥45 years of age mailed hemoccult slides, 10,255 (70.3) returned them at the time of their examination. One hundred twelve (1.1) were positive, and 12 colorectal carcinomas were detected. Additionally, 13 patients with one or more polyps ≥1 cm and 45 patients with other gastrointestinal sources of blood were found. Of the screened cases of colorectal carcinoma, 50 were in Dukes' stage A compared with 25 found in this stage in our institution in 1974, when screening was not done. Five-year Dukes' stage-specific medical care costs and mortality rates were developed from the 1974 cases and were then applied to the screened cases of colorectal cancer. A savings in medical care costs of $14,685 and a projected increase of 22 years in life expectancy was fo
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