This therapeutic regimen has provided enhanced local control and decreased metastases. Furthermore, the marked degree of tumor downstaging, as seen by a 27% incidence of sterile pathologic specimens and a low rate of positive lymph nodes in this group with initially advanced lesions, strongly suggest that less radical surgery and sphincter preservation may be used with increasing frequency.

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Hereditary hemochromatosis is a serious condition of abnormal iron metabolism that is often missed until complications involving multiple organ systems occurs. It is an autosomal recessive condition primarily affecting Caucasians of Western European origin. This article discusses the pathophysiology, diagnosis, and management of this condition. Questions related to population screening are examined and recommendations made for a cost-effective screening program.