Screening for colorectal carcinoma

Colorectal carcinoma will occur in some 147,000 Americans this year. This disease accounts for 15% of all cancers and 12% of all cancer deaths. Screening for colorectal carcinoma may allow the disease process to be found earlier and, in some situations such as when polyps are found and removed, may even prevent the disease. The two main modalities of screening are fecal occult blood tests and sigmoidoscopy. By general screening of asymptomatic patients as well as by selective screening of those at high risk, there is hope that the incidence and mortality of this cancer will diminish. Absolute confirmation of this benefit is still lacking, making the evaluation of the cost-effectiveness of this screening somewhat questionable. Current educational efforts are designed to increase compliance and to help solve some of these unanswered questions.