Screening for colorectal cancer

Colorectal cancer is the third most commonly diagnosed cancer and the secon d leading cause of cancer deaths in the United States. Fortunately, both th e incidence and mortality associated with the disease have declined during the past 2 decades. This is likely due, at least in part, to improved effor ts at screening and more aggressive removal of adenomatous polyps. However, colorectal cancer screening is still generally underutilized. This article reviews the current status and future outlook for colorectal cancer screen ing, including a discussion of risk factors for the disease, its anatomic d istribution, proposed mechanisms of development from adenomatous polyps, ra tionale for screening, and screening options. Published literature concerni ng the cost-effectiveness of colorectal cancer screening is also summarized . The article concludes with a discussion of the emerging consensus regardi ng the importance of and approaches to screening.