Diagnosing colorectal carcinoma: clinical and molecular approaches

In summary, the ability to decrease the mortality of colorectal carcinoma is increasingly within the grasp of clinicians. With accurate family and personal history, it is possible to estimate the risk of colorectal cancer and initiate FOBT and colonoscopy where appropriate. In the future, germline and even somatic genetic testing will further increase our ability to diagnose cancers before they become widely invasive. As molecular biology unravels the cause of what currently appears to be the majority of sporadic cancers, it may be possible to characterize more colorectal cancers that are caused by novel, as yet not recognized mutator genes. Unfortunately, a set of patients is likely to exist who remain to be diagnosed by symptoms caused by advanced cancer. The goal for the clinician is to decrease this subset to as small a group as possible.