The Current Guidelines and Recommended Protocols for Screening Colorectal Cancer
Salman Yousuf GurayaDepartment of Surgery, College of Medicine, Taibah University, Almadinah Almunwwarah Saudi Arabia.
Corresponding Author E-mail: salmanguraya@gmail.com
Abstract: Colorectal cancer (CRC) is a major cancer with significant morbidity and mortality among men and women, particularly in the Western countries. With more countries adopting awestern lifestyle, the burden of CRC continues to growacross the globe. Coinciding with the alarming rise in the incidence of CRC, there is a pressing need for a reciprocal concerted effort to underpin the significance of CRC screening strategies and to modernize the cutting-edge CRC screening modalities. Depending on the cancer subsite distribution, available resources and expertise, and geographic representation of cancer, a myriad of CRC screening techniques are employed worldwide. Colonoscopy is the gold standard test that carries great promise owing to its diagnostic and therapeutic potentials, however, its current use is limited to surveillance colonoscopy for high risk patients or when highly suspicious lesions are detected by flexible sigmoidoscopy. Fecal occult blood testing (FOBT) is effective and reliable but a low compliance rate jeopardizes its cumulative usefulness as this test needs to be done annually by adults people aged 50 years and above. Computed tomographic (CT)colonography is recommended after positive FOBT in cases when colonoscopy is not feasible or incomplete. The value of flexible sigmoidoscopy in CRC screening is fading out except for the low socio-economic regions primarily due to its limited visualization of the colon and the need for colonoscopy in case of detecting polyp in distal colon by flexible sigmoidoscopy. Fecal DNA testing is another promising screening technique that can potentially detect advanced precancerous and cancerous growths in the lower gastrointestinal tract. The World Health Organization (WHO) has recommended that all adults above 50 years of age are potentially at risk of developing CRC, and should have FOBT annually and colonoscopy every 5 years. However, the preferences for choosing cancer screening strategies are primarily driven by individual risk, available resources and personal choice
Keywords: Colorectal cancer; cancer screening; colonoscopy;CT colonography; Fecal occult blood test Back to TOC