ABSTRACT
The World Health Organization (WHO)1 and the Council of Europe2 have both published principles regarding screening as a tool for cancer prevention and early detection. Screening is the testing of healthy people for diseases that have so far not given rise to symptoms. Colorectal cancer fulfils the conditions that have been defined for mass screening: it is a major cause of morbidity and mortality in industrialized countries, with an estimated number of 198 000 new cases reported in the 15 member states of the European Union in 1995.3 Despite advances in diagnostic techniques and treatment, the 5-year survival rates remain poor.4 However, colorectal cancer can be cured if detected at an early age, and in certain cases can be prevented by the removal of adenomas. Considerable research efforts have been launched over the last 15 years to evaluate the ability of screening tests to decrease colorectal cancer mortality and incidence. Currently, the simplest screening method for colorectal cancer is periodic stool testing for occult blood. The most extensively evaluated test is the Hemoccult II (Smith Kline Diagnostic, California). The purpose of this chapter is to consider the evidence for screening for colorectal cancer based on published studies.
