Early diagnosis of colorectal cancer

It is reasonable to suggest that survival in colorectal cancer is closely linked to the anatomical stage of the tumour, implying that detection and removal of less advanced cancers will lead to a prolongation of survival. Early diagnosis of colorectal cancer therefore should be an important goal to strive for. An effort to achieve early diagnosis may be based on identification of high risk patients, and screening of groups at intermediate risk of developing colorectal cancer. Patients with well defined precancerous conditions should be included in surveillance programme. Prophylactic surgical treatment should be considered in longstanding ulcerative colitis and familial polyposis syndrome. Improved methods of genetic mapping and identification of the genetic defects that predisposed to cancer will probably be of great importance in the future. To reach groups of the population for early diagnosis of colorectal cancer large-scale screening is probably necessary. A change towards less advanced cancers is likely to be the result of mass screening. Improved survival with acceptable cost-benefit ratio remains to be shown.