COLORECTAL-CANCER SCREENING - PRESENT STRATEGIES AND FUTURE-PROSPECTS

Considerable controversy remains mains as to what represents the most effective and cost-effective approach to screening for colorectal canc er, The American Cancer Society (ACS), whose guidelines are the most w idely used in the United States, recommends annual fecal occult blood testing and flexible sigmoidoscopy every 3 to 5 years beginning at age 50 in asymptomatic, average-risk individuals, However the high rates of false-positive and false-negative results associated with the fecal occult blood testing techniques currently available continue to repre sent a concern, There is sufficient information to encourage patients and physicians to comply with ACS recommendations for colorectal cance r screening, However, reducing the mortality and morbidity of colorect al cancer will require advances in screening methodology as well as ne w methods of educating both the public and physicians about the import ance of screening, Future screening strategies may include improved fe cal occult blood testing, use of colonoscopy (as either a one-time or a periodic examination), and molecular genetic testing performed on fe ces or blood, Advances in understanding of genetic alterations in colo rectal cancer will undoubtedly improve our ability to target aggressiv e screening strategies and implement preventive measures.