title: Population-based screening in colorectal cancer - current practice and future developments: faecal biomarkers review.
abstract: OBJECTIVE
  Colorectal cancer (CRC) is the second most common form of malignancy in Europe and North America, and is one of the major causes of cancer death, with a 50.7% 5 year mortality rate. The majority of cases are of a sporadic nature and develop from a pre-cancerous lesion. Screening programmes have been introduced in many countries to detect and treat the condition. These mostly rely on a combination of faecal occult blood tests and endoscopy to guide diagnosis. They are expensive to establish and run, have a potential for false negatives (especially for high risk adenomas and right sided cancers) and they are often unacceptable to a significant percentage of the at-risk population. Consequently many groups have sought sensitive and specific diagnostic biomarkers for CRC and adenomas. These biomarkers form three broad categories: cytogenetic, enzymatic/protein and metabolomic.
  
  
  METHODS
  Pubmed and Medline databases were searched to identify relevant articles concerning colorectal cancer screening.
  
  
  CONCLUSIONS
  Here we provide a review of the current population-based screening possibilities and faecal biomarkers currently under investigation, an assessment of their cost-effectiveness, their efficacy and suggestions for the future of large scale screening in CRC.
authors.affiliation: Department of Gastroenterology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK. Chris.Probert@liverpool.ac.uk.
authors.forename: David
authors.initials: D
authors.lastname: Sawbridge
authors.affiliation: Department of Gastroenterology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Probert
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D003113:Colonoscopy / Q000009:adverse effects / Q000191:economics; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000191:economics / Q000379:methods* / Q000639:trends; D005243:Feces / Q000737:chemistry*; D006801:Humans; D009780:Occult Blood; D010342:Patient Acceptance of Health Care; D011364:Professional Practice / Q000639:trends
chemical_list: D014408:Biomarkers, Tumor