Population-based screening in colorectal cancer - current practice and future developments: faecal biomarkers review
Journal of Gastrointestinal and Liver Diseases
REVIEW ABSTRACT Background & Aims: Colorectal cancer (CRC) is the second most common form of malignancy in Europe and North America, and is one of the major causes of cancer death, with a 50.7% 5 year mortality rate. e majority of cases are of a sporadic nature and develop from a pre-cancerous lesion. Screening programmes have been introduced in many countries to detect and treat the condition. ese mostly rely on a combination of faecal occult blood tests and endoscopy to guide diagnosis. ey
... de diagnosis. ey are expensive to establish and run, have a potential for false negatives (especially for high risk adenomas and right sided cancers) and they are o en unacceptable to a signi cant percentage of the at-risk population. Consequently many groups have sought sensitive and speci c diagnostic biomarkers for CRC and adenomas. ese biomarkers form three broad categories: cytogenetic, enzymatic/protein and metabolomic. Methods: Pubmed and Medline databases were searched to identify relevant articles concerning colorectal cancer screening. Conclusion: Here we provide a review of the current population-based screening possibilities and faecal biomarkers currently under investigation, an assessment of their cost-e ectiveness, their e cacy and suggestions for the future of large scale screening in CRC.