Colorectal cancer screening.
OBJECTIVE
The review will summarize the state of the art in colon cancer screening. Recently published screening guidelines will be reviewed so physicians can understand them and how to deal with the differences. Each screening modality presently in use will then be reviewed with emphasis on efficacy and problems.


RESULTS
During the past two decades research has clearly demonstrated colon cancer screening to be effective. New modalities such as virtual colonoscopy and stool DNA screening have been introduced and are recommended by some organizations but not others. Ages to discontinue screening have also been suggested. Fecal immunochemical testing exhibits some advantages over guaiac-based testing. Problematic issues with the effectiveness of colonoscopy have arisen, particularly in the proximal colon. Both technical and biological reasons have been suggested for this decrease in effectiveness.


CONCLUSIONS
Colon cancer screening is effective and continues to improve. Refinements of guidelines as well as refinements in each screening modality have occurred. Several screening tools are newly available and quality studies and efforts for present and new tests are imperative.
Burt
Randall W
RW
Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, USA. randall.burt@hci.utah.edu
D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity