Colorectal carcinoma: is screening possible?
Colorectal cancer (CRC) is a major health problem in western countries. It is the most frequently diagnosed cancer in EU countries with about 220,000 new cases per year; the number of CRC deaths approaches 112,000. Most cancer arises from adenomatous polyps through the adenoma-carcinoma sequence; the natural history of the disease is long: the risk of invasive cancer in adenoma is about 2% per year. Given the natural history of CRC, early diagnosis represents the most appropriate tool to reduce the disease-related mortality. Several tests are available to screen healthy subjects at average risk for CRC: faecal occult blood tests, flexible sigmoidoscopy, combined faecal occult blood tests and flexible sigmoidoscopy, total colonoscopy and double contrast barium enema. Issues related to the introduction on a large scale of population-based screening programmes for CRC are discussed.
Bonelli
L
L
Unit of Secondary Prevention and Screening, National Institute for Cancer Research, Largo R. Benzi 10, I-16132 Genoa, Italy. luigina.bonelli@istge.it
D000236:Adenoma / Q000175:diagnosis*; D018256:Adenomatous Polyps / Q000175:diagnosis; D001466:Barium Sulfate; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D004733:Enema; D008403:Mass Screening / Q000379:methods*; D009780:Occult Blood; D012680:Sensitivity and Specificity; D012812:Sigmoidoscopy
D001466:Barium Sulfate