Colorectal cancer screening in asymptomatic populations.
Colorectal cancer is the second commonest cause of cancer death in the UK.
An effective national screening programme is urgently required to reduce the substantial morbidity and mortality from the disease.
The success of any screening programme will depend on the screening test detecting early Dukes's A carcinomas and adenomatous polyps.
Prognosis is directly related to tumour staging and a proportion of carcinomas are thought to arise from polyps.
Two screening methods exist - faecal occult blood testing and sigmoidoscopy.
Large trials of faecal occult blood testing show that it detects more early lesions than in patients presenting with symptoms, but whether this reduces mortality is not yet confirmed and lack of sensitivity for cancers and polyps may ultimately limits its usefulness.
The role of sigmoidoscopy in screening, particularly flexible sigmoidoscopy, has not been fully investigated.
Flexible sigmoidoscopy has a greater sensitivity for distal lesions than stool testing and a randomised controlled trial of its efficacy is planned inBritain.
Compliance with screening is essential to ensure its cost effectiveness in both health and economic terms.
Large trials of faecal occult blood testing conducted over several years achieved compliance rates in excess of 60%, although in smaller studies these are often much less.
Women frequently participate more than men.
Mots-clés Pascal : Epithélioma glandulaire, Polype adénomateux, Dépistage, Stade précoce, Recherche, Sang, Fèces, Sigmoïdoscopie, Résultat, Homme, Grande Bretagne, Royaume Uni, Europe, Appareil digestif pathologie, Côlon pathologie, Tumeur maligne
Mots-clés Pascal anglais : Adenocarcinoma, Adenomatous polyp, Medical screening, Early stage, Research, Blood, Feces, Sigmoidoscopy, Result, Human, Great Britain, United Kingdom, Europe, Digestive diseases, Colonic disease, Malignant tumor
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0232591
Code Inist : 002B30A03A. Création : 09/06/1995.