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JNCI Journal of the National Cancer Institute 2002 94(15):1126-1133; doi:10.1093/jnci/94.15.1126
© 2002 by Oxford University Press
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Journal of the National Cancer Institute, Vol. 94, No. 15, 1126-1133, August 7, 2002
© 2002 Oxford University Press

COMMENTARY

Colorectal Cancer Screening for Persons at Average Risk

William F. Anderson, Kate Z. Guyton, Robert A. Hiatt, Sally W. Vernon, Bernard Levin, Ernest Hawk

Affiliations of authors: W. F. Anderson, E. Hawk (Division of Cancer Prevention/Gastrointestinal and Other Cancer Research Group), R. A. Hiatt (Division of Cancer Control and Population Sciences), National Cancer Institute, Bethesda, MD; K. Z. Guyton, CCS Associates, Mountain View, CA; S. W. Vernon, School of Public Health, University of Texas, Houston; B. Levin, The University of Texas M. D. Anderson Cancer Center, Houston.

Correspondence to: William F. Anderson, M.D., M.P.H., NCI/Division of Cancer Prevention/Gastrointestinal and Other Cancer Research Group, EPN, Room 2144, 6130 Executive Blvd., Bethesda, MD 20892-7317 (e-mail: wanderso@mail.nih.gov).

The first 150 words of the full text of this article appear below.

BACKGROUND

In the United States, colorectal carcinoma (CRC) is the fourth most frequently diagnosed and the second most common cause of cancer-specific death for both men and women (1). The lifetime risk of developing CRC is approximately 6% (2), and treatment costs nearly $6 billion annually (3). As for most epithelial cancers, CRC age-specific incidence increases continuously with biologic aging, with the greatest risk occurring in those individuals aged 80 years or older (2) (Fig. 1Go). Of the more than 148 000 estimated new CRC cases in the year 2002 (4), approximately 40% are expected to die within 5 years (2). Death from CRC is especially unfortunate, given that CRC prevention often can be achieved through screening (5).


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  		Fig. 1. Age-specific colorectal cancer incidence rate (or age-specific colorectal cancer risk) from 1995 through 1999, . . . [Full Text of this Article]

 
ROUTINE AND EMERGING CRC SCREENING TECHNOLOGIES FOR PERSONS AT AVERAGE RISK

Stool-Based Screening Tests

Fecal occult blood test (FOBT). Fecal multi-targeted DNA-based assay panel (MTAP) test. Endoscopic Screening Strategies

Flexible sigmoidoscopy (FS). Annual FOBT combined with FS every 5 years. Colonoscopy. Emerging endoscopic technologies. X-Ray Screening Strategies

DCBE. Virtual colonoscopy. VALID ENDPOINTS FOR ASSESSMENT OF COLORECTAL CANCER SCREENING

Colorectal Cancer Endpoints

Colorectal Adenoma Endpoints

BARRIERS TO ROUTINE COLORECTAL CANCER SCREENING

RESEARCH CHALLENGES AND OPPORTUNITIES FOR THE NEXT 3–5 YEARS

1) One of the most appropriate target lesions for CRC screening and prevention is the adenoma.

2) At present, there is no preferred CRC screening strategy.

3) A definitive randomized clinical trial of colonoscopy screening with a mortality endpoint is highly desirable but may not be feasible.

4) Reducing barriers to routine colorectal cancer screening recommendations is a priority.

Summary. APPENDIX A

Speakers:

APPENDIX B

Attendees:


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