Current status of screening for colorectal cancer
Open Access
- 25 April 2013
- journal article
- review article
- Published by Elsevier BV in Annals of Oncology
- Vol. 24 (8), 1963-1972
- https://doi.org/10.1093/annonc/mdt157
Abstract
Colorectal cancer (CRC) is a leading cause of cancer morbidity and mortality. A well-defined precursor lesion (adenoma) and a long preclinical course make CRC a candidate for screening. This paper reviews the current evidence for the most important tests that are widely used or under development for population-based screening. In this narrative review, we scrutinized all papers we have been aware of, and carried out searches in PubMed and Cochrane library for relevant literature. Two screening methods have been shown to reduce CRC mortality in randomised trials: repetitive faecal occult blood testing (FOBT) reduces CRC mortality by 16%; once-only flexible sigmoidoscopy (FS) by 28%. FS screening also reduces CRC incidence (by 18%), FOBT does not. Colonoscopy screening has a potentially larger effect on CRC incidence and mortality, but randomised trials are lacking. New screening methods are on the horizon but need to be tested in large clinical trials before implementation in population screening. FS screening reduces CRC incidence and CRC mortality by removal of adenomas; FOBT reduces CRC mortality by early detection of cancer. Several other tests are available, but none has been evaluated in randomised trials. Screening strategies differ considerably across countries.This publication has 96 references indexed in Scilit:
- Adherence to Colorectal Cancer ScreeningJAMA Internal Medicine, 2012
- Participation and yield of colonoscopy versus non-cathartic CT colonography in population-based screening for colorectal cancer: a randomised controlled trialThe Lancet Oncology, 2012
- The Relationship Between Distal and Proximal Colonic Neoplasia: A Meta-AnalysisJournal of General Internal Medicine, 2011
- Comparison of Guaiac-Based and Quantitative Immunochemical Fecal Occult Blood Testing in a Population at Average Risk Undergoing Colorectal Cancer ScreeningThe American Journal of Gastroenterology, 2010
- Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trialThe Lancet, 2010
- Magnetic resonance (MR) colonography in the detection of colorectal lesions: a systematic review of prospective studiesEuropean Radiology, 2009
- Immunochemical faecal occult blood test: number of samples and positivity cutoff. What is the best strategy for colorectal cancer screening?British Journal of Cancer, 2009
- Survival benefit in a randomized clinical trial of faecal occult blood screening for colorectal cancerBritish Journal of Surgery, 2008
- Randomised study of screening for colorectal cancer with faecal-occult-blood testThe Lancet, 1996
- Randomised controlled trial of faecal-occult-blood screening for colorectal cancerThe Lancet, 1996