Models of screening program for colorectal cancer

Colorectal cancer is one of the most frequent neoplasms in western countries, with an estimated 400,000 deaths per year throughout the world. The results of treatment vary widely, depending on the extent of the disease. In particular, the disease stage at diagnosis by the Dukes' modified classification is significantly correlated with prognosis. Colonoscopic polypectomy substantially reduces CRC incidence in comparison to that expected in the general population. These results are of particular relevance considering that people with adenomas are at increased risk for CRC. These observations strengthen the concept of effective population screening in view of the fact that adenomatous polyps are the most frequent neoplastic outcome of screening. Today we have new opportunities for CRC secondary prevention and it is time to start public awareness campaigns and involve gastroenterologists and general practitioners in a common effort.