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In response to the editorial on colon cancer reduction,¹ we would like to point out an additional potentially severe complication associated with cancer screening using a flexible sigmoidoscope or colonoscope—the fairly high probability that the screened patient will be exposed to a contaminated endoscope. According to the US Preventive Services Task Force,² "An individual's lifetime risk of dying of colorectal cancer in the U.S. has been estimated to be 2.6%." However, as researched by the US Food and Drug Administration and 3 state departments of health³: "A total of 23.9% of the bacterial cultures from the internal channels of 71 gastrointestinal endoscopes grew 100,000 colonies or more of bacteria." As a result, they report that "outbreaks with substantial morbidity and mortality have occurred."

Detailed guidelines for the proper cleaning, high-level disinfecting, and rinsing of flexible endoscopes are available.^4-7 It is imperative that endoscopists implement these guidelines, so that the . . . [Full Text of this Article]