Current Colorectal Cancer Reports

, Volume 8, Issue 1, pp 32–35 | Cite as

Should There Be Gender Differences in the Guidelines for Colorectal Cancer Screening?

  • Jaroslaw Regula
  • Anna Chaber
  • Michal F. Kaminski
Prevention and Early Detection (N Arber, Section Editor)


Colorectal cancer screening guidelines are identical for men and women despite reported differences in epidemiology, endoscopy performance, screening preferences, and screening uptake. High-quality research is needed to determine whether gender aspects may in real world increase acceptance and overcome screening barriers, which may lead to better use of limited resources allocated for public health.


Colorectal cancer Screening Gender Prevention and early detection 



No potential conflicts of interest relevant to this article were reported.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Boyle P, Ferlay J. Cancer incidence and mortality in Europe, 2004. Ann Oncol. 2005;16:481–8.PubMedCrossRefGoogle Scholar
  2. 2.
    Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA Cancer J Clin. 2008;58:71–96.PubMedCrossRefGoogle Scholar
  3. 3.
    Segnan N, Patnick J, von Karsa L, editors. European Guidelines for quality assurance in colorectal cancer screening and diagnosis. 1st ed. Luxembourg: European Commission, Publications Office of the European Union; 2010.Google Scholar
  4. 4.
    Brenner H, Hoffmeister M, Arndt V, Haug U. Gender differences in colorectal cancer: implications for age at initiation of screening. Br J Cancer. 2007;96:828–31.PubMedCrossRefGoogle Scholar
  5. 5.
    Regula J, Rupinski M, Kraszewska E, et al. Colonoscopy in colorectal-cancer screening for detection of advanced neoplasia. N Engl J Med. 2006;355:1863–72.PubMedCrossRefGoogle Scholar
  6. 6.
    •• Ferlitsch M, Reinhart K, Pramhas S et al. Sex-specific prevalence of adenomas, advanced adenomas, and colorectal cancer in individuals undergoing screening colonoscopy. JAMA. 2011;306(12):1352–8. This recently published study shows a difference of about 10 years in prevalence of advanced adenomas between men and women. PubMedCrossRefGoogle Scholar
  7. 7.
    • Nguyen SP, Bent S, Chen Y-H, Terdiman JP. Gender as a risk factor for advanced neoplasia and colorectal cancer: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2009;7:676–81. This meta-analysis confirms that risk for advanced neoplasia is higher in men. PubMedCrossRefGoogle Scholar
  8. 8.
    Hoffmeister M, Schmitz S, Karmrodt E, et al. Male sex and smoking have a larger impact on the prevalence of colorectal neoplasm than family history of colorectal cancer. Clin Gastroenterol Hepatol. 2010;8(10):870–6.Google Scholar
  9. 9.
    Denis B, Reutsch M, Strentz P, et al. Short term outcomes of the first round of a pilot colorectal cancer screening programme with guaiac based faecal occult blood test. Gut. 2007;56:1579–84.PubMedCrossRefGoogle Scholar
  10. 10.
    •• Lansdorp-Vogelaar I, van Ballegooijen M, Zauber AG, et al. Individualizing colonoscopy screening by sex and race. Gastrointest Endosc. 2009;70:96–108. In this study, a micro-simulation model was used to estimate cost-effectiveness of individualizing colonoscopy screening by gender and race. PubMedCrossRefGoogle Scholar
  11. 11.
    McCashland TM, Brand R, Lyden E, de Garmo Pat, AP CORI Research Project. Gender differences in colorectal polyps and tumors. Am J Gastroenterol. 2001;96:882–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Schoenfeld P, Cash B, Flood A, et al. Colonoscopic screening of average-risk women for colorectal neoplasia. N Engl J Med. 2005;352:2061–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Imperiale TF, Wagner DR, Lin CY, et al. Risk of advanced proximal neoplasms in asymptomatic adults according to the distal colorectal findings. N E J Med. 2000;343:169–74.CrossRefGoogle Scholar
  14. 14.
    Rex DK, Cummings OW, Helper DJ, et al. 5-year incidence of adenomas after negative colonoscopy in asymptomatic average-risk persons. Gastroenterology. 1996;111:1178–81.PubMedCrossRefGoogle Scholar
  15. 15.
    Brenner H, Haug U, Arndt V, et al. Low risk of colorectal cancer and advanced adenomas more than 10 years after negative colonoscopy. Gastroenterology. 2010;138:870–6.PubMedCrossRefGoogle Scholar
  16. 16.
    Stewart BT, Keck JO, Duncan AV, et al. Difficult or incomplete flexible sigmoidoscopy: implications for a screening programme. Aust N Z J Surg. 1999;69:19–21.PubMedCrossRefGoogle Scholar
  17. 17.
    Eloubeidi MA, Wallace MB, Desmond R, et al. Female gender and other factors predictive of a limited screening flexible sigmoidoscopy examination for colorectal cancer. Am J Gastroenterol. 2003;98:1634–9.PubMedCrossRefGoogle Scholar
  18. 18.
    Adams C, Cardwell C, Cook C, et al. Effect of hysterectomy status on polyp detection rates at screening flexible sigmoidoscopy. Gastrointest Endosc. 2003;57:848–53.PubMedCrossRefGoogle Scholar
  19. 19.
    Saunders BP, Fukumoto M, Halligan S, et al. Why is colonoscopy more difficult in women? Gastrointest Endosc. 1996;43:124–6.PubMedCrossRefGoogle Scholar
  20. 20.
    Aslinia F, Uradomo L, Steele A, et al. Quality assessment of colonoscopic cecal intubation: an analysis of 6 years of continuous practice at a university hospital. Am J Gastroenterol. 2006;101:721–31.PubMedCrossRefGoogle Scholar
  21. 21.
    Hoff G, Bretthauer M, Huppertz-Hauss G, et al. The Norwegian Gastronet project: continuous quality improvement of colonoscopy in 14 Norwegian centres. Scand J Gastroenterol. 2006;41:481–7.PubMedCrossRefGoogle Scholar
  22. 22.
    Thiis-Evensen E, Hoff GS, Sauar J, et al. Patient tolerance of colonoscopy without sedation during screening examination for colorectal polyps. Gastrointest Endosc. 2000;52:606–10.PubMedCrossRefGoogle Scholar
  23. 23.
    Kim WH, Cho YJ, Park JY, et al. Factors affecting insertion time and patient discomfort during colonoscopy. Gastrointest Endosc. 2000;52:600–5.PubMedCrossRefGoogle Scholar
  24. 24.
    Early DS, Saifuddin T, Johnson JC, et al. Patient attitudes toward undergoing colonoscopy without sedation. Am J Gastroenterol. 1999;94:1862–5.PubMedCrossRefGoogle Scholar
  25. 25.
    Ko CW, Riffle S, Shapiro JA, et al. Incidence of minor complications and time lost from normal activities after screening or surveillance colonoscopy. Gastrointest Endosc. 2007;65:648–56.PubMedCrossRefGoogle Scholar
  26. 26.
    McQueen A, Vernon SW, Meissner HI, et al. Are there gender differences in colorectal cancer test use prevalence and correlates? Cancer Epidemiol Biomarkers Prev. 2006;15:782–91.PubMedCrossRefGoogle Scholar
  27. 27.
    Stockwell DH, Woo P, Jacobson BC, et al. Determinants of colorectal cancer screening in women undergoing mammography. Am J Gastroenterol. 2003;98:1875–80.PubMedCrossRefGoogle Scholar
  28. 28.
    Farraye FA, Wong M, Hurwitz S, et al. Barriers to endoscopic colorectal cancer screening: are women different from men? Am J Gastroenterol. 2004;99:341–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Menees SB, Inadomi JM, Korsnes S, Elta GH. Women patients’ preference for women physicians is a barrier to colon cancer screening. Gastrointest Endosc. 2005;62:219–23.PubMedCrossRefGoogle Scholar
  30. 30.
    Fidler H, Hartnett A, Cheng Man K, et al. Sex and familiarity of colonoscopists: patient preferences. Endoscopy. 2000;32:481–2.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Jaroslaw Regula
    • 1
    • 2
    • 3
  • Anna Chaber
    • 1
    • 2
  • Michal F. Kaminski
    • 1
    • 2
  1. 1.Department of Gastroenterology and HepatologyMedical Center for Postgraduate EducationWarsawPoland
  2. 2.Maria Sklodowska-Curie Memorial Cancer Center and Institute of OncologyWarsawPoland
  3. 3.Institute of OncologyWarsawPoland

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