[Colorectal cancer mass screening: present and future]

Area of Science:

• Oncology
• Gastroenterology
• Public Health

Context:

• Colorectal cancer (CRC) screening is crucial for mortality reduction.
• Hemoccult II fecal occult blood testing is the only method proven effective by randomized controlled trials.
• Current French screening strategies need expansion and public engagement.

Purpose:

• To evaluate the effectiveness of different colorectal cancer screening methods.
• To discuss the public health implications of expanding CRC screening in France.
• To compare guaiac-based tests, immunochemical tests, colonoscopy, sigmoidoscopy, and virtual colonoscopy.

Summary:

• Hemoccult II, a guaiac smear test, has proven efficacy in reducing CRC mortality.
• Immunochemical fecal occult blood tests offer higher sensitivity than guaiac tests, particularly for adenomas.
• While virtual colonoscopy is promising, established methods should be prioritized for broad expansion.

Impact:

• Effective CRC screening strategies, including media campaigns and public involvement, are essential for public health.
• Medicoeconomic data will guide the selection of future screening technologies.
• Widespread participation in CRC screening requires consideration of healthcare professional and public opinions.