[Objectives and means of screening of colorectal cancer]

Despite numerous publications on the subject, the debate over the merits of the various methods available for screening for colorectal cancer is continuing. Choice of the method depends on the patient being treated. In the present state of our knowledge, mass screening by Hemoccult, which is of low cost but of poor sensitivity and only fairly well accepted, cannot be used routinely but must be further evaluated and developed. In persons willing to undergo regular examinations, an annual or biannual Hemoccult examination associated with rectosigmoidoscopy every 5 years appears appropriate. In subjects having a familial history in first-degree relatives, colonoscopic examination every 5 years is adequate. Lastly, in patients with a personal history of cancer or adenoma, screening consists of colonoscopic follow-up adapted to the individual case.