Screening for rectal cancer.
Although screening for rectal cancer remains a controversial topic, the case for screening has been strengthened by the demonstration that screening can reduce mortality from the disease. Three randomized controlled trials based on fecal occult blood testing have shown a significant reduction in overall colorectal cancer mortality in those offered testing. The case for screening based on flexible sigmoidoscopy is not as strong. Evidence from randomized controlled trials will not be available for another 8-10 years. Whatever screening method is chosen, factors such as the level of participation and the cost-effectiveness of protocols for adenoma follow-up will have major effects on the success of screening.
St John
D J
DJ
Department of Gastroenterology, Royal Melbourne Hospital, Australia. james.stjohn@nwhcn.org.av
D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D008403:Mass Screening; D009780:Occult Blood; D016032:Randomized Controlled Trials as Topic; D012812:Sigmoidoscopy; D015996:Survival Rate