HOW TO SCREEN FOR COLON-CANCER

The biology of colorectal cancer provides a unique opportunity for ear ly detection and prevention. There is now evidence that screening of a symptomatic average-risk individuals over 50 years of age can reduce m ortality resulting from colorectal cancer. New recommendations from th e US Preventive Services Task Force endorse screening with fecal occul t blood tests or sigmoidoscopy. The best method for population screeni ng remains uncertain. The cost of screening is an important issue in t he development of public policy. This review discusses the various scr eening options, examines the ''downstream'' effects of screening, and reviews the anticipated costs and effectiveness. Ultimately, the effec tiveness of any screening program depends on patient compliance. Furth er research is needed to determine the best methods of enhancing patie nt adherence to a screening program.