D Cumulative Index Medicus listed 3,775 papers on the subject of carcinoma of colon and rectum. Despite the experience represented by these publications and the advances reported in methods of diagnosis, techniques of treatment, and 5-year survival rates, the mortality rate has been unresponsive. The rate per 1 0 0 , o ~ population was 33.1 in 1930 and 37.5 in 1958.1 Published statistics of the results of treatment seem to give a rather hopeful prognosis for selected patients with operable tumors. Mayo and Cullen11 reported "When the hospital deaths and palliative procedures are excluded, the 5 year survival rate was 61.3 per cent and the 10 year survival rate was 52.6 per cent." Stearns and DeddishlS reported on I22 patients undergoing abdominoperineal resection. "There was 66 (54%) five-year survivors. The survival rate for those classified according to Dukes' method as A, B and C was 83, 58 and 40 per cent, respectively." Wilson and TennantlS summarized "The absolute 5-year survival for cancer of the colon and rectum in our series of 950 cases from 1941 to 1950 was 28%. After curative resection, it was 46%." Deddish, Stearns, Binkley, and Loseke7 confirmed the general observation of 50 to 600/, 5-year survival in selected series although they do refer to an over-all salvage of 8.2%.
There was uniform agreement among authors that earlier diagnosis is still the primary requirement for improvement in results. "The need is for earlier as well as more radical surgery. . . . " 8 "Any increase in the survival rates of right colon carcinoma must stem principally from earlier diagnosis as provided by a constant awareness of the problem. . . ." la " 'Cancer detection' implies the discovery of malig-From the