Screening by Colonoscopy - Has the Time Arrived?

• Main Author: Richard H Hunt
• Format: Article
• Language: English
• Published: Hindawi Limited 1990-01-01
• Series: Canadian Journal of Gastroenterology
• Online Access: http://dx.doi.org/10.1155/1990/939740

Colorectal cancer mortality may be reduced by several screening strategies - mathematical modelling suggests that mortality may be reduced by one-third in patients over the age of 40 years who undergo annual fecal occult blood testing. Similar modelling suggests that either colonoscopy or barium enema may reduce mortality by up to 85%. This paper reviews the evidence for different screening approaches for colorectal cancer, and identifies high risk groups in whom full colonoscopy has been studied. These studies include patients with first degree relatives with colorectal cancer, family cancer syndrome, prior breast, uterine or ovarian lesions, and follow-up for prior adenomatous polyps or cancer. The role of colonoscopy in the surveillance of patients with chronic total ulcerative colitis for dysplasia is also reviewed. The implications for patient management and possible clinical strategies are discussed.