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Recent developments in colorectal cancer screening and prevention
Michael Pignone1, Bernard Levin
1Division of General Internal Medicine, University of North Carolina at Chapel Hill School of Medicine, 27599-7110, USA. pignone@med.unc.edu
American Family Physician
|August 3, 2002
Summary
Colorectal cancer screening, including fecal occult blood testing, is proven effective and cost-effective. New research supports existing methods and explores promising new tools to reduce cancer incidence and mortality in adults over 50.
Area of Science:
- Gastroenterology
- Oncology
- Preventive Medicine
Background:
- Colorectal cancer (CRC) significantly impacts US morbidity and mortality.
- Early 1990s studies established CRC screening's mortality reduction benefits, leading to recommendations for adults over 50.
- Despite recommendations, national CRC screening rates remain low.
Purpose of the Study:
- To review recent advancements in colorectal cancer screening and prevention.
- To highlight new findings on the effectiveness and sensitivity of various screening modalities.
- To discuss novel screening tools and preventive strategies.
Main Methods:
- Review of recent studies (past four years) on colorectal cancer screening and prevention.
- Analysis of trial results, sensitivity comparisons, and cost-effectiveness models.
- Evaluation of preliminary data on emerging screening and prevention methods.
Main Results:
- Fecal occult blood testing (FOBT) effectiveness in reducing CRC incidence and mortality is further supported.
- New studies compare the sensitivity of FOBT, sigmoidoscopy, and double-contrast barium enema against colonoscopy.
- Screening via multiple methods is cost-effective compared to no screening.
- Calcium supplements show efficacy in preventing adenomatous polyp recurrence, while fiber does not.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), DNA stool tests, and virtual colonoscopy show potential.
Conclusions:
- Recent evidence reinforces the importance of colorectal cancer screening and prevention for adults over 50.
- Existing screening methods are effective and cost-effective, with ongoing research refining their application.
- Emerging technologies like DNA stool tests and virtual colonoscopy offer future promise for improved screening.