As family physicians, we are honored by the invitation to collaborate in the discussion to decrease death rates from colorectal cancer via earlier detection and treatment. Studies presented here share the common thread of increased access and improved compliance through a new colonoscopy technique, which is less painful and can be provided at a lower cost. This technique should allow decreased dependence on highly regulated and costly hospital-based services, which frequently generate charges of more than $3,000 per colonoscopy. In other words, more services might be provided to more people at a lower cost. Although screening of asymptomatic patients is one issue, our early studies described the reality of communities where symptomatic patients could not or would not comply with recommendations for colonoscopy/flexible sigmoidoscopy.