WHATS NEW IN COLORECTAL-CANCER SCREENING

There is now good evidence from case-control studies and randomized co ntrolled trials that screening average-risk subjects for colorectal ca ncer using faecal occult blood tests reduces mortality. There is limit ed data indicating that screening sigmoidoscopy can also achieve this. There is no evidence yet that screening by colonoscopy or double cont rast barium enema can reduce mortality. Calculations of cost-effective ness suggest that all of the above strategies should be economically w orthwhile but there is no convincing evidence to suggest that one stra tegy is markedly more cost-effective than the others. Further data on several aspects of screening are required before any decisions are mad e on which form(s) of screening should be offered nationwide.