Objectives: Performing full colonoscopy at regular intervals and remov
ing lesions at an early stage might significantly lower the incidence
and mortality of colorectal cancer. Such a program must be inexpensive
, safe, and time-efficient. Methods: Screening colonoscopy was perform
ed on 639 patients. For a normal examination, the physician's time is
limited to giving the medication for conscious sedation, performing th
e colonoscopy, and completing a written report form. The total charge
for a normal screening colonoscopy is $150. Results: Adenomatous and/o
r hyperplastic polyps were detected in 218 patients (34.1%). One hundr
ed sixty adenomatous and 134 hyperplastic polyps were removed. Forty-e
ight percent (48.1%) of the adenomatous and 21.6% of the hyperplastic
polyps were above the sigmoid colon. Six adenocarcinomas were detected
in five patients. One patient had a delayed bleeding episode requirin
g no transfusion or therapeutic intervention, and one patient had a ''
post-polypectomy syndrome'' requiring no therapeutic intervention. The
average physician time in the endoscopy room for normal examinations
was 18 min. Conclusions: Screening colonoscopy can be safely performed
in an office facility. Physician time with the patient should be limi
ted to allow a low cost that compares favorably with screening costs f
or other malignancies. Long-term studies to assess the capability of s
creening colonoscopy to lower mortality from colorectal cancer should
continue.