The Hewiston review highlights via meta analysis that there was a 16% (95% CI 0.78, 0.

90) reduction of CRC mortality when screening by FOBT occurred (as according to Fig 1.). Whilst FOBT significantly decreased CRC related mortality, it had no statistically significant effect on all cause mortality with a RR of 1 (95% CI 0.99, 1.01). This comparison is VERY important, as it suggests that the cause of death, even if prevented by screening, may be insufficient to warrant a population based screening program (as the net benefit to society may be negligible). To thus justify such interventions a Cost Benefit Analysis should be performed to assess if such a program is financially viable to the anticipated benefit (and from further reading I am happy to say it is!). A key factor to remember is that targeted screening programs for high risk populations would increase the technical efficiency (maximising benefit produced per investigation with higher yields from higher risk groups) and increase the allocative efficiency (maximising distribution of resources to where they can best be utilised), which is why the FOBT screening is run the way it is in Australia.