Colorectal cancer screening: tests, strategies and perspectives
Screening has a central role in colorectal cancer (CRC) control. Different screening tests are effective in reducing CRC-specific mortality. Influence on cancer incidence depends on test sensitivity for premalignant lesions, ranging from almost no influence for guaiac-based fecal occult blood testin...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2014-10-01
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| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fpubh.2014.00210/full |
| _version_ | 1811334842827145216 |
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| author | Fabrizio eStracci Fabrizio eStracci Manuel eZorzi Grazia eGrazzini |
| author_facet | Fabrizio eStracci Fabrizio eStracci Manuel eZorzi Grazia eGrazzini |
| author_sort | Fabrizio eStracci |
| collection | DOAJ |
| description | Screening has a central role in colorectal cancer (CRC) control. Different screening tests are effective in reducing CRC-specific mortality. Influence on cancer incidence depends on test sensitivity for premalignant lesions, ranging from almost no influence for guaiac-based fecal occult blood testing (gFOBT) to an estimated reduction of 66-90% for colonoscopy. Screening tests detect lesions indirectly in the stool (gFOBT, fecal immunochemical testing – FIT –, fecal DNA) or directly by colonic inspection (flexible sigmoidoscopy, colonoscopy, CT colonography, capsule endoscopy). CRC screening is cost-effective compared to no screening but no screening strategy is clearly better than the others. Stool tests are the most widely used in worldwide screening interventions. FIT will soon replace gFOBT. The use of colonoscopy as a screening test is increasing and this strategy has superseded all alternatives in the US and Germany. Despite its undisputed importance, CRC screening is underused and participation rarely reaches 70% of target population. Strategies to increase participation include ensuring recommendation by physicians, introducing organized screening and developing new, more acceptable tests. Available evidence for DNA fecal testing, CT colonography and capsule endoscopy is reviewed. |
| first_indexed | 2024-04-13T17:15:11Z |
| format | Article |
| id | doaj.art-f7842142f05a4a8eb2387fd00a95bc3b |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-13T17:15:11Z |
| publishDate | 2014-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-f7842142f05a4a8eb2387fd00a95bc3b2022-12-22T02:38:09ZengFrontiers Media S.A.Frontiers in Public Health2296-25652014-10-01210.3389/fpubh.2014.00210116829Colorectal cancer screening: tests, strategies and perspectivesFabrizio eStracci0Fabrizio eStracci1Manuel eZorzi2Grazia eGrazzini3University of Perugia, ItalyRegional Cancer Registry of UmbriaRegistro Tumori del VenetoISPO Cancer Prevention and Research InstituteScreening has a central role in colorectal cancer (CRC) control. Different screening tests are effective in reducing CRC-specific mortality. Influence on cancer incidence depends on test sensitivity for premalignant lesions, ranging from almost no influence for guaiac-based fecal occult blood testing (gFOBT) to an estimated reduction of 66-90% for colonoscopy. Screening tests detect lesions indirectly in the stool (gFOBT, fecal immunochemical testing – FIT –, fecal DNA) or directly by colonic inspection (flexible sigmoidoscopy, colonoscopy, CT colonography, capsule endoscopy). CRC screening is cost-effective compared to no screening but no screening strategy is clearly better than the others. Stool tests are the most widely used in worldwide screening interventions. FIT will soon replace gFOBT. The use of colonoscopy as a screening test is increasing and this strategy has superseded all alternatives in the US and Germany. Despite its undisputed importance, CRC screening is underused and participation rarely reaches 70% of target population. Strategies to increase participation include ensuring recommendation by physicians, introducing organized screening and developing new, more acceptable tests. Available evidence for DNA fecal testing, CT colonography and capsule endoscopy is reviewed.http://journal.frontiersin.org/Journal/10.3389/fpubh.2014.00210/fullscreeningcolorectal canceradvanced adenomaguaiac-based fecal occult blood testfecal immunochemical testflexible sigmoidoscopy |
| spellingShingle | Fabrizio eStracci Fabrizio eStracci Manuel eZorzi Grazia eGrazzini Colorectal cancer screening: tests, strategies and perspectives Frontiers in Public Health screening colorectal cancer advanced adenoma guaiac-based fecal occult blood test fecal immunochemical test flexible sigmoidoscopy |
| title | Colorectal cancer screening: tests, strategies and perspectives |
| title_full | Colorectal cancer screening: tests, strategies and perspectives |
| title_fullStr | Colorectal cancer screening: tests, strategies and perspectives |
| title_full_unstemmed | Colorectal cancer screening: tests, strategies and perspectives |
| title_short | Colorectal cancer screening: tests, strategies and perspectives |
| title_sort | colorectal cancer screening tests strategies and perspectives |
| topic | screening colorectal cancer advanced adenoma guaiac-based fecal occult blood test fecal immunochemical test flexible sigmoidoscopy |
| url | http://journal.frontiersin.org/Journal/10.3389/fpubh.2014.00210/full |
| work_keys_str_mv | AT fabrizioestracci colorectalcancerscreeningtestsstrategiesandperspectives AT fabrizioestracci colorectalcancerscreeningtestsstrategiesandperspectives AT manuelezorzi colorectalcancerscreeningtestsstrategiesandperspectives AT graziaegrazzini colorectalcancerscreeningtestsstrategiesandperspectives |