Screening for colorectal cancer in the average-risk population☆

A review is presented of the attempts made by screening to decrease mortality from colorectal cancer in the average-risk population above 50 years of age. No ideal methods are available, but the one that fulfills most of the criteria for screening includes fecal occult blood testing (FOBT), followed by colonoscopy in those with a positive test. The strategy has been proven effective in several case-control studies and 3 larger randomized trials, but it remains to be seen whether it will be successfully performed in mass screening of countrywide populations. Reductions of 15% to 30% in mortality from colorectal cancer have been obtained in those invited for screening and 30% to 50% in individuals actually being screened. Other methods are being evaluated at the present time, but results will not be available for some years, making it necessary now to implement screening with FOBTs in countries with high incidence and mortality from colorectal cancer. Copyright © 2002 by W.B. Saunders Company