An updated review of the methods, guidelines of, and controversies on screening for colorectal cancer

Sameh Hany Emile; Samer Hani Barsom; Steven D Wexner

doi:10.1016/j.amjsurg.2022.03.034

An updated review of the methods, guidelines of, and controversies on screening for colorectal cancer

Am J Surg. 2022 Jul;224(1 Pt B):339-347. doi: 10.1016/j.amjsurg.2022.03.034. Epub 2022 Mar 25.

Authors

Sameh Hany Emile¹, Samer Hani Barsom², Steven D Wexner³

Affiliations

¹ Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA; Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt.
² Nephrology and Hypertension Division, Internal Medicine Department, Mayo Clinic, Rochester, MN, USA.
³ Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA. Electronic address: wexners@ccf.org.

PMID: 35367029
DOI: 10.1016/j.amjsurg.2022.03.034

Abstract

Background: Screening for early detection of colorectal cancer (CRC), adenomatous polyps, and precancerous lesions can reduce mortality. This review aimed to illustrate methods, guidelines, and clinical utility of CRC screening programs.

Methods: Literature search of PubMed and Scopus electronic databases was independently performed by two authors in September 2021. Articles discussing CRC screening methods and updated guidelines were reviewed.

Results: After reviewing the full text of 55 studies, it was found that the screening tests for CRC are divided into stool-based, endoscopic, and molecular. All CRC screening guidelines recommend screening starting at age 45-50, but vary regarding screening methods, frequency, and timing of screening discontinuation. Controversies include clinical benefits of screening the elderly and discontinuation of screening. Effective screening barriers involve patient- and healthcare-related factors.

Conclusion: Overall, screening should start at age 45-50 for average-risk individuals. Colonoscopy and FIT tests are standard modalities recommended for regular screening. Increasing public awareness of the importance of screening and implementing mass national screening programs can detect early CRC and decrease related mortality.

Keywords: CRC; Colorectal cancer; Comprehensive; Review; Screening.

Publication types

Review

MeSH terms

Aged
Colonoscopy
Colorectal Neoplasms* / diagnosis
Early Detection of Cancer* / methods
Humans
Mass Screening / methods
Middle Aged