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KMID : 1039620130030020139
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Korean Journal of Family Practice
2013 Volume.3 No. 2 p.139 ~ p.146
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Colorectal Cancer Screening
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Kim Yeol
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Abstract
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Colorectal cancer is the third most common cancer in Korea, and its incidence is increasing. As early detection and treatment of the cancer can increase survival rate, colorectal cancer is a subject for early screening. Moreover, as it is well known that most forms of colorectal cancer develop from adenomas, early detection and removal of adenomas can prevent colorectal cancer. Fecal occult blood test (FOBT) is the easiest and most common screening method for colorectal cancer. FOBT has proven to be effective in reducing colorectal cancer related death on the basis of randomized controlled trials. As for the methods of FOBT, the immunochemical test is known to be more accurate than traditional Guaiac methods. Recently, a stool DNA test has been introduced as a new method for early detection of colorectal cancer. Other screening methods for colorectal cancer are sigmoidoscopy, colonoscopy, double contrast barium enema (DCBE), and computed tomography (CT) colonography (virtual colonoscopy). Colorectal cancer screening is recommended for persons aged 50 or older. It is minimally effective over age 75, and is not effective over age 85. The colorectal cancer screening test intervals vary by test methods. Sigmoidoscopy, DCBE, and CT colonography are recommended every five years. Colonoscopy is recommended at a maximum of 10-year intervals. Sigmoidoscopy is found to be more effective when it is combined with FOBT because sigmoidoscopy cannot detect proximal colon lesions. Although the stool DNA test and CT colonography are suggested as available methods for colorectal cancer screening, their accuracy and ffectiveness are not proven yet. DCBE is used less often than in the past because of its low accuracy and radiation exposure issues.
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KEYWORD
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Colorectal Neoplasms, Mass Screening, Feces, Occult Blood, Sigmoidoscopy, Colonoscopy, Double Contrast Barium Enema, Computed Tomographic Colonography
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