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Screening guidelines for colorectal cancer.

O Kronborg1

  • 1Dept. of Surgical Gastroenterology, Odense University Hospital, Denmark.

Scandinavian Journal of Gastroenterology. Supplement
|January 1, 1992
PubMed
Summary
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Screening for colorectal cancer involves various methods for average and high-risk individuals. Combining fecal occult blood tests with flexible sigmoidoscopy may significantly reduce mortality in average-risk populations.

Area of Science:

  • Oncology
  • Gastroenterology
  • Preventive Medicine

Background:

  • Colorectal cancer (CRC) screening is crucial for early detection and mortality reduction.
  • Current screening methods vary in effectiveness for average-risk and high-risk populations.

Purpose of the Study:

  • To review existing methods and outcomes for colorectal cancer screening.
  • To evaluate the efficacy of different screening modalities in average-risk and high-risk groups.
  • To propose recommendations for high-risk group screening.

Main Methods:

  • Review of digital rectal examination, endoscopic examination, barium enemas, fecal occult blood tests (FOBT), tumor markers (CEA, Ca-19-9), and gene markers.
  • Analysis of results from large randomized population studies on FOBT.

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  • Evaluation of proposed screening guidelines for high-risk populations.

    • Main Results:

    • Fecal occult blood tests are a key screening method, with large-scale study results pending.
    • Combining fecal occult blood tests with flexible sigmoidoscopy is likely necessary to substantially decrease colorectal cancer mortality in average-risk individuals.
    • Screening recommendations for high-risk groups exist but lack robust supporting evidence, with notable exceptions for specific genetic predispositions.

    Conclusions:

    • Flexible sigmoidoscopy combined with fecal occult blood tests shows promise for reducing colorectal cancer mortality in average-risk individuals.
    • Further research and evidence are needed to solidify screening guidelines for various high-risk groups.
    • Personalized screening strategies are essential for optimizing colorectal cancer prevention across different risk strata.