Colorectal cancer screening

Colorectal cancer is a common and devastating disease. Many authorities recommend screening asymptomatic person, although the benefit of such screening is without scientific validation. Each of the screening modalities available has been examined, and their merits and shortcomings have been discussed. Surveys have indicated that primary care physicians generally agree with screening asymptomatic patients, but only a minority actually comply with the recommendations. Patient acceptance also varies. Thus, while specialty boards and panels of experts attempt to arrive at policies for the general population, primary care physicians must interact with the individual patient. Until data from ongoing prospective screening studies are available and cost-benefit issues are resolved, screening for colorectal cancer will remain at the discretion of physicians and their patients. There is insufficient evidence to support either continuing or discontinuing the recommended examinations for asymptomatic patients. The screening examinations can be recommended on the basis of a theoretical benefit, however. They can be performed with a minimum of risk of injury or side effects. Certain patients can be identified as being at above-average risk and deserving of more consideration. If aware of the benefits and limitations of colorectal cancer screening, primary care physicians can decide how to implement colorectal cancer screening in their clinical practice.