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Screening for Colon Polyps and Cancer

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Epidemiologic Studies in Cancer Prevention and Screening

Part of the book series: Statistics for Biology and Health ((SBH,volume 79))

Abstract

Colorectal cancer (CRC) carries a significant health burden, accounting for 610,000 deaths worldwide in 2008. CRC is the fourth most common malignancy and the second leading cause of cancer-related death in the United States. Colon screening is arguably the greatest cancer prevention success story of the last 25 years contributing substantially to over a 40 % reduction in CRC mortality in the USA since 1975. Screening rates in the USA currently exceed 60 % and are steadily rising. Randomized screening trials have demonstrated a 33 % reduction in CRC mortality with the use of annual fecal occult blood testing (FOBT) and a 27–31 % reduction in CRC mortality with flexible sigmoidoscopy (FS). Despite this robust evidence for FOBT and FS, colonoscopy use has been on the rise in the USA and has emerged as the preferred colon screening modality. Colonoscopy has a conceptual advantage as it is the only single-step test that allows visualization of the entire colon and removal of polyps simultaneously. Retrospective data suggests that colonoscopy may not be as protective of colon cancer in the proximal colon; however, prospective data on the impact of colonoscopy screening on incidence and mortality is not yet available. Computerized tomography colonography (CTC) and fecal DNA testing are newer technologies that have a great deal of potential as screening modalities as technology advances. Although colon screening can be expensive depending on the test used, any type of screening appears to be cost-effective when taking into account the rising costs of CRC treatment.

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Authors and Affiliations

  1. University of Colorado School of Medicine, Aurora, CO, USA

    Swati G. Patel M.S., M.D. (Fellow in Gastroenterology)

  2. Denver Department of Veterans Affairs Medical Center, University of Colorado School of Medicine, Denver, CO, USA

    Dennis J. Ahnen M.D.

  3. S/M Gastroenterology, Gastroenterology Administration, A009/111E, VA Hospital Room 8C157, Denver, CO, USA

    Dennis J. Ahnen M.D.

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  1. Swati G. Patel M.S., M.D.
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Correspondence to Dennis J. Ahnen M.D. .

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Editors and Affiliations

  1. University of Toronto, 392 Lakeshore Road East, Oakville, L6J 1J8, Ontario, Canada

    Anthony B. Miller

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Patel, S.G., Ahnen, D.J. (2013). Screening for Colon Polyps and Cancer. In: Miller, A. (eds) Epidemiologic Studies in Cancer Prevention and Screening. Statistics for Biology and Health, vol 79. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5586-8_16

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