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Colon cancer: detection and prevention.
David E Loren1, James Lewis, Michael L Kochman
1Division of Gastroenterology, Department of Medicine, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, 3 Ravdin, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Gastroenterology Clinics of North America
|July 24, 2002
Summary
Colonoscopic screening is preferred for colonic neoplasia detection. Unresolved issues include surveillance, HNPCC kindred management, Bethesda criteria validation, and new technologies for colon cancer management.
Area of Science:
- Gastroenterology and Oncology
- Colorectal Cancer Screening and Management
Background:
- Advances in detecting, surveying, and managing colonic neoplasia are significant.
- Colonoscopic screening is increasingly favored over less invasive tests like fecal occult blood testing (FOBT) or fecal stool testing (FS) for selected individuals.
Purpose of the Study:
- To address unresolved issues in colonic neoplasia management.
- To highlight areas requiring further research and validation in clinical practice.
Main Methods:
- Review of current studies and consensus statements on colonic neoplasia screening.
- Discussion of unresolved clinical questions and emerging technologies.
Main Results:
- Colonoscopy is supported for screening, but specific surveillance protocols and management of hereditary non-polyposis colorectal cancer (HNPCC) kindreds require clarification.
- Prospective validation of Bethesda criteria for mortality reduction is pending.
- Prophylaxis strategies and the role of new technologies like virtual colonoscopy are under investigation.
Conclusions:
- Despite advancements, significant questions remain in optimizing colonic neoplasia detection, surveillance, and management.
- Further research is needed to validate current criteria and explore the utility of novel diagnostic and screening technologies for colon cancer.