ABSTRACT

Survival for colon and rectal carcinoma is closely related to the clinical and pathologic stage of the disease at diagnosis. Colorectal carcinoma fulfills all the criteria for justified screening. Screening identifies individuals who are more likely to have colorectal carcinoma or adenomatous polyps from among those without signs or symptoms of disease. The goal of screening for colorectal carcinoma is to reduce mortality from the disease. Screening people at average risk for colorectal carcinoma is different from screening people at high risk. Clinicians should determine an individual patient’s risk status well before the earliest potential initiation of screening. Case-controlled studies have reported that sigmoidoscopy was associated with reduced mortality for colorectal carcinoma. A randomized controlled trial of sigmoidoscopy with follow-up colonoscopy for all patients with polyps compared with no screening demonstrated a significant reduction in colorectal carcinoma incidence in the screened patients.