Colorectal cancer screening: Choosing the right test

Abstract

Colorectal cancer, the second most common type of cancer and cause of cancer-related deaths in the United States, can largely be prevented by screening. The 2 most used methods in the United States are colonoscopy and fecal immunochemical testing (FIT). FIT is noninvasive but must be done yearly for optimal performance and, if positive, must be followed by colonoscopy. Colonoscopy is invasive, operator-dependent, and more expensive, but it can detect and remove polyps during the same procedure. The choice of test depends on patient preference, family history, and the likelihood of compliance. KEY POINTS Colorectal cancer rates are increasing in young individuals, with 10,000 new cases reported in 2017 in people ages 20 to 49. The evidence to support screening at ages 45 to 50 is not well established. FIT is noninvasive but requires high patient adherence and the ability to follow a multistep process. Preliminary results from one trial showed it inferior to colonoscopy for detecting colorectal cancer precursors. Colonoscopy allows visualization and removal of precursor lesions. A positive FIT result requires follow-up colonoscopy within 10 months.

The effectiveness of walking exercise on the bowel preparation before colonoscopy: a single blind randomized clinical trial study

“…Using colonoscopy to screen colorectal cancer can lead to less incidence and mortality in the general population [ 37 , 38 ]. Colonoscopy is the most common method used for colorectal cancer screening in the United States [ 39 ].…”

Métodos de rastreo del cáncer de colon

“…Los dos métodos más difundidos para el rastreo son la VCC cada 10 años y los estudios de sangre oculta en materia fecal (SOMF), variando el intervalo entre estudios entre 1 y 3 años 2 . En este caso se enfatizó en la prueba inmunoquímica fecal (PIF), variante que demostró tener mayor sensibilidad y especificidad que otras pruebas de sangre oculta en materia fecal 3 , y que de manera adicional, tiene la ventaja de que sólo requiere una muestra para realizar la detección. Si bien la VCC es el estándar de oro para la detección de CCR, la PIF es un estudio no invasivo y posiblemente más económico, que además puede ser mejor aceptado por los pacientes 4 .…”

Detection of Upper Gastrointestinal Disorders in Patients with Positive Fecal Immunochemical Test (FIT) and Normal Colonoscopy: A Cross-Sectional Study

“…With the use of screening methods, this disease can be detected in its early stages, leading to prevention of severe clinical outcomes. 1 If CRC is detected early, the 5-year survival rate is of 93.2%, whereas the same rate for individuals with metastatic disease is of only 8.1%. 2 Based on existing guidelines, CRC screening is recommended in individuals > 50 years of age.…”