Strategies for Colorectal Cancer Screening

Gastroenterology. 2020 Jan;158(2):418-432. doi: 10.1053/j.gastro.2019.06.043. Epub 2019 Aug 5.

Abstract

The incidence of colorectal cancer (CRC) is increasing worldwide. CRC has high mortality when detected at advanced stages, yet it is also highly preventable. Given the difficulties in implementing major lifestyle changes or widespread primary prevention strategies to decrease CRC risk, screening is the most powerful public health tool to reduce mortality. Screening methods are effective but have limitations. Furthermore, many screen-eligible people remain unscreened. We discuss established and emerging screening methods, and potential strategies to address current limitations in CRC screening. A quantum step in CRC prevention might come with the development of new screening strategies, but great gains can be made by deploying the available CRC screening modalities in ways that optimize outcomes while making judicious use of resources.

Keywords: Colonoscopy; Fecal Immunochemical Test; Fecal Occult Blood Test; Sigmoidoscopy.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Colonoscopy / standards
  • Colonoscopy / statistics & numerical data
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / epidemiology
  • Colorectal Neoplasms / prevention & control
  • Early Detection of Cancer / standards*
  • Early Detection of Cancer / statistics & numerical data
  • Global Burden of Disease*
  • Health Plan Implementation / standards*
  • Healthy Lifestyle
  • Humans
  • Incidence
  • Mass Screening / organization & administration
  • Mass Screening / standards*
  • Mass Screening / statistics & numerical data
  • Occult Blood
  • Patient Acceptance of Health Care / statistics & numerical data
  • Practice Guidelines as Topic
  • Risk Assessment / standards
  • Sigmoidoscopy / standards
  • Sigmoidoscopy / statistics & numerical data