Screening for Colorectal Neoplasms

  • Thomas E. Read
  • Philip F. Caushaj
Reference work entry

Abstract

Cancer of the colon and rectum is the second leading cause of cancer-related death in the United States. In 1997, it was estimated that 131,000 Americans were diagnosed with colorectal cancer, and 55,000 died from this disease. Without undergoing screening or preventive action, approximately 1 in every 17 people in this country will develop colorectal cancer at some point in life. However, evidence is mounting that colorectal adenocarcinoma can be prevented by detecting and removing adenomatous polyps, and that detecting early-stage cancers reduces mortality from the disease. Both polyps and early-stage cancers are usually asymptomatic; cancers that have grown large enough to cause symptoms have a much worse prognosis. This contrast highlights the need for screening in asymptomatic persons.

Keywords

Colorectal Cancer Familial Adenomatous Polyposis Fecal Occult Blood Test Adenomatous Polyp Colorectal Cancer Screening 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Parker SL, Tong T, Bolden S, Wingo PA. Cancer statistics, 1997. CA Cancer J Clin 1997;47:5–27.CrossRefPubMedGoogle Scholar
  2. 2.
    Newcomb P, Norfleet R, Storer B, Surawicz T, Marcus P. Screening sigmoidoscopy and colorectal cancer mortality. J Natl Cancer Inst 1992;84:1572–1575.CrossRefPubMedGoogle Scholar
  3. 3.
    Kronborg O, Fenger C, Olsen J, Jorgensen OD, Sondergaard O. Randomised study of screening for colorectal cancer with faecal‐occult‐blood test. Lancet 1996;348:1467–1471.CrossRefPubMedGoogle Scholar
  4. 4.
    Winawer SJ, Flehinger BJ, Schottenfeld D, Miller DG. Screening for colorectal cancer with fecal occult blood testing and sigmoidoscopy. J Natl Cancer Inst 1993;85:1311–1318.CrossRefPubMedGoogle Scholar
  5. 5.
    Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med 1993;329:1977–1981.CrossRefPubMedGoogle Scholar
  6. 6.
    Muller AD, Sonnenberg A. Protection by endoscopy against death from colorectal cancer. A case‐control study among veterans. Arch Intern Med 1995;155:1741–1748.CrossRefPubMedGoogle Scholar
  7. 7.
    Winawer SJ, Fletcher RH, Miller L, et al. Colorectal cancer screening: clinical guidelines and rationale. Gastroenterology 1997;112:594–642.CrossRefPubMedGoogle Scholar
  8. 8.
    Frame PS, Berg AO, Woolf S. U.S. Preventive Services Task Force: highlights of the 1996 report. Am Fam Physician 1997;55:567–576, 581–582.PubMedGoogle Scholar
  9. 9.
    Levin B, Bond JH. Colorectal cancer screening: recommendations of the U.S. Preventive Services Task Force. American Gastroenterological Association. Gastroenterology 1996;111: 1381–1384.CrossRefPubMedGoogle Scholar
  10. 10.
    Laken SJ, Petersen GM, Gruber SB, et al. Familial colorectal cancer in Ashkenazim due to a hypermutable tract in APC. Nat Genet 1997;17:79–83.CrossRefPubMedGoogle Scholar
  11. 11.
    Byers T, Levin B, Rothenberger D, Dodd GD, Smith RA. American Cancer Society guidelines for screening and surveillance for early detection of colorectal polyps and cancer: update 1997. American Cancer Society Detection and Treatment Advisory Group on Colorectal Cancer. CA Cancer J Clin 1997;47:154–160.CrossRefPubMedGoogle Scholar
  12. 12.
    Simmang CL, Senatore P, Lowry A, et al. Practice parameters for detection of colorectal neoplasms. The Standards Committee, The American Society of Colon and Rectal Surgeons. Dis Colon Rectum 1999;42:1123–1129.CrossRefPubMedGoogle Scholar
  13. 13.
    Rockey DC, Koch J, Cello JP, Sanders LL, McQuaid K. Relative frequency of upper gastrointestinal and colonic lesions in patients with positive fecal occult‐blood tests. N Engl J Med 1998;339:153–159.CrossRefPubMedGoogle Scholar
  14. 14.
    Hardcastle JD, Chamberlain JO, Robinson MH, et al. Randomised controlled trial of faecal‐occult‐blood screening for colorectal cancer. Lancet 1996;348:1472–1477.CrossRefPubMedGoogle Scholar
  15. 15.
    Mandel JS, Bond JH, Church TR, et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med 1993;328:1365–1371.CrossRefPubMedGoogle Scholar
  16. 16.
    Anderson LM, May DS. Has the use of cervical, breast, and colorectal cancer screening increased in the United States? Am J Public Health 1995;85:840–842.CrossRefPubMedGoogle Scholar
  17. 17.
    Ransohoff DF, Lang CA. Screening for colorectal cancer with the fecal occult blood test: a background paper. American College of Physicians. Ann Intern Med 1997;126:811–822.PubMedGoogle Scholar
  18. 18.
    Nakama H, Fattah AS, Zhang B, Kamijo N. Digital rectal examination sampling of stool is less predictive of significant colorectal pathology than stool passed spontaneously. Eur J Gastroenterol Hepatol 2000;12:1235–1238.CrossRefPubMedGoogle Scholar
  19. 19.
    Colorectal Cancer Screening: Clinical Practice Guidlines in Oncology. JNCCN 2003;1:72–93.Google Scholar
  20. 20.
    Traverso G, Shuber A, Levin B, et al. Detection of APC mutations in fecal DNA from patients with colorectal tumors. N Engl J Med 2002;346:311–320.CrossRefPubMedGoogle Scholar
  21. 21.
    Limburg PJ, Devens ME, Harrington JJ, Diehl NN, Mahoney DW, Ahlquist DA. Prospective evaluation of fecal calprotectin as a screening biomarker for colorectal neoplasia. Am J Gastroenterol 2003;98:2299–2305.CrossRefPubMedGoogle Scholar
  22. 22.
    Read TE, Read JD, Butterly LF. Importance of adenomas 5 mm or less in diameter that are detected by sigmoidoscopy. N Engl J Med 1997;336:8–12.CrossRefPubMedGoogle Scholar
  23. 23.
    Selby J, Friedman G, Quesenberry C, Weiss N. A case‐control study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med 1992;326:653–657.CrossRefPubMedGoogle Scholar
  24. 24.
    Thiis‐Evensen E, Hoff GS, Sauar J, Langmark F, Majak BM, Vatn MH. Population‐based surveillance by colonoscopy: effect on the incidence of colorectal cancer. Telemark Polyp Study I. Scand J Gastroenterol 1999;34:414–420.CrossRefPubMedGoogle Scholar
  25. 25.
    Thiis‐Evensen E, Hoff GS, Sauar J, Majak BM, Vatn MH. The effect of attending a flexible sigmoidoscopic screening program on the prevalence of colorectal adenomas at 13‐year follow‐up. Am J Gastroenterol 2001;96:1901–1907.CrossRefPubMedGoogle Scholar
  26. 26.
    Atkin WS, Edwards R, Wardle J, et al. Design of a multicentre randomised trial to evaluate flexible sigmoidoscopy in colorectal cancer screening. J Med Screen 2001;8:137–144.CrossRefPubMedGoogle Scholar
  27. 27.
    Lieberman D, Smith F. Screening for colon malignancy with colonoscopy. Am J Gastroenterol 1991;86:946–951.PubMedGoogle Scholar
  28. 28.
    Achkar E, Carey W. Small polyps found during fiberoptic sigmoidoscopy in asymptomatic patients. Ann Intern Med 1988; 109:880–883.PubMedGoogle Scholar
  29. 29.
    Brady PG, Straker RJ, McClave SA, Nord HJ, Pinkas M, Robinson BE. Are hyperplastic rectosigmoid polyps associated with an increased risk of proximal colonic neoplasms? Gastrointest Endosc 1993;39:481–485.CrossRefPubMedGoogle Scholar
  30. 30.
    Rex DK, Smith JJ, Ulbright TM, Lehman GA. Distal colonic hyperplastic polyps do not predict proximal adenomas in asymptomatic average‐risk subjects. Gastroenterology 1992;102: 317–319.PubMedGoogle Scholar
  31. 31.
    Mehran A, Jaffe P, Efron J, Vernava A, Liberman A. Screening colonoscopy in the asymptomatic 50‐ to 59‐year‐old population. Surg Endosc 2003;17(12):1974–1977.CrossRefPubMedGoogle Scholar
  32. 32.
    Steine S, Stordahl A, Lunde OC, Loken K, Laerum E. Double‐contrast barium enema versus colonoscopy in the diagnosis of neoplastic disorders: aspects of decision‐making in general practice. Fam Pract 1993;10:288–291.CrossRefPubMedGoogle Scholar
  33. 33.
    Hixson LJ, Fennerty MB, Sampliner RE, McGee D, Garewal H. Prospective study of the frequency and size distribution of polyps missed by colonoscopy. J Natl Cancer Inst 1990;82: 1769–1772.CrossRefPubMedGoogle Scholar
  34. 34.
    Hixson LJ, Fennerty MB, Sampliner RE, Garewal HS. Prospective blinded trial of the colonoscopic miss‐rate of large colorectal polyps. Gastrointest Endosc 1991;37:125–127.CrossRefPubMedGoogle Scholar
  35. 35.
    Fork FT. Double contrast enema and colonoscopy in polyp detection. Gut 1981;22:971–977.CrossRefPubMedGoogle Scholar
  36. 36.
    Fenlon HM, Nunes DP, Clarke PD, Ferrucci JT. Colorectal neoplasm detection using virtual colonoscopy: a feasibility study. Gut 1998;43:806–811.CrossRefPubMedGoogle Scholar
  37. 37.
    Rex DK. CT and MR colography (virtual colonoscopy): status report. J Clin Gastroenterol 1998;27:199–203.CrossRefPubMedGoogle Scholar
  38. 38.
    Akerkar GA, Yee J, Hung R, McQuaid K. Patient experience and preferences toward colon cancer screening: a comparison of virtual colonoscopy and conventional colonoscopy. Gastrointest Endosc 2001;54:310–315.CrossRefPubMedGoogle Scholar
  39. 39.
    Fenlon HM, Nunes DP, Schroy PC 3rd, Barish MA, Clarke PD, Ferrucci JT. A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. N Engl J Med 1999;341:1496–1503.CrossRefPubMedGoogle Scholar
  40. 40.
    Pickhardt PJ, Choi JR, Hwang I, et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 2003;349:2191–2200.CrossRefPubMedGoogle Scholar
  41. 41.
    Wagner JL. Cost‐effectiveness of screening for common cancers. Cancer Metastasis Rev 1997;16:281–294.CrossRefPubMedGoogle Scholar
  42. 42.
    Wagner J. From the Congressional Office of Technology Assessment. JAMA 1990;264:2732.CrossRefPubMedGoogle Scholar
  43. 43.
    Bull Am Coll Surg 1998;83:13.Google Scholar
  44. 44.
    Walsh JM, Terdiman JP. Colorectal cancer screening: scientific review. JAMA 2003;289:1288–1296.CrossRefPubMedGoogle Scholar
  45. 45.
    Winawer SJ, Zauber AG, O'Brien MJ, et al. Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. The National Polyp Study Workgroup. N Engl J Med 1993;328:901–906.CrossRefPubMedGoogle Scholar
  46. 46.
    Read TE, Mutch MG, Chang BW, et al. Locoregional recurrence and survival after curative resection of adenocarcinoma of the colon. J Am Coll Surg 2002;195:33–40.CrossRefPubMedGoogle Scholar
  47. 47.
    Winawer SJ, Zauber AG, Gerdes H, et al. Risk of colorectal cancer in the families of patients with adenomatous polyps. National Polyp Study Workgroup. N Engl J Med 1996;334:82–87.CrossRefPubMedGoogle Scholar
  48. 48.
    Fuchs CS, Giovannucci EL, Colditz GA, Hunter DJ, Speizer FE, Willett WC. A prospective study of family history and the risk of colorectal cancer. N Engl J Med 1994;331:1669–1674.CrossRefPubMedGoogle Scholar
  49. 49.
    Frayling IM, Beck NE, Ilyas M, et al. The APC variants I1307K and E1317Q are associated with colorectal tumors, but not always with a family history. Proc Natl Acad Sci USA 1998;95: 10722–10727.CrossRefPubMedGoogle Scholar
  50. 50.
    Gryfe R, Di NN, Lal G, Gallinger S, Redston M. Inherited colorectal polyposis and cancer risk of the APC I1307K polymorphism. Am J Hum Genet 1999;64:378–384.CrossRefPubMedGoogle Scholar
  51. 51.
    Prior TW, Chadwick RB, Papp AC, et al. The I1307K polymorphism of the APC gene in colorectal cancer. Gastroenterology 1999;116:58–63.CrossRefPubMedGoogle Scholar
  52. 52.
    Rozen P, Shomrat R, Strul H, et al. Prevalence of the I1307K APC gene variant in Israeli Jews of differing ethnic origin and risk for colorectal cancer. Gastroenterology 1999;116:54–57.CrossRefPubMedGoogle Scholar
  53. 53.
    Woodage T, King SM, Wacholder S, et al. The APCI1307K allele and cancer risk in a community‐based study of Ashkenazi Jews. Nat Genet 1998;20:62–65.CrossRefPubMedGoogle Scholar
  54. 54.
    Gryfe R, Di NN, Gallinger S, Redston M. Somatic instability of the APC I1307K allele in colorectal neoplasia. Cancer Res 1998;58:4040–4043.PubMedGoogle Scholar
  55. 55.
    Burke W, Petersen G, Lynch P, et al. Recommendations for follow‐up care of individuals with an inherited predisposition to cancer. I. Hereditary nonpolyposis colon cancer. Cancer Genetics Studies Consortium. JAMA 1997;277:915–919.CrossRefPubMedGoogle Scholar
  56. 56.
    Lynch HT, Smyrk T. Hereditary nonpolyposis colorectal cancer (Lynch syndrome). An updated review. Cancer 1996;78: 1149–1167.CrossRefPubMedGoogle Scholar
  57. 57.
    Myrhoj T, Bisgaard ML, Bernstein I, Svendsen LB, Sondergaard JO, Bulow S. Hereditary non‐polyposis colorectal cancer: clinical features and survival. Results from the Danish HNPCC register. Scand J Gastroenterol 1997;32:572–576.CrossRefPubMedGoogle Scholar
  58. 58.
    Rodriguez‐Bigas MA, Boland CR, HamiltonSR, et al. A National Cancer Institute Workshop on Hereditary Nonpolyposis Colorectal Cancer Syndrome: meeting highlights and Bethesda guidelines. J Natl Cancer Inst 1997;89:1758–1762.CrossRefPubMedGoogle Scholar
  59. 59.
    Box JC, Rodriguez‐Bigas MA, Weber TK, Petrelli NJ. Clinical implications of multiple colorectal carcinomas in hereditary nonpolyposis colorectal carcinoma. Dis Colon Rectum 1999;42: 717–721.CrossRefPubMedGoogle Scholar
  60. 60.
    Fitzgibbons RJ Jr, Lynch HT, Stanislav GV, et al. Recognition and treatment of patients with hereditary nonpolyposis colon cancer (Lynch syndromes I and II). Ann Surg 1987;206:289–295.CrossRefPubMedGoogle Scholar
  61. 61.
    Watson P, Lin KM, Rodriguez‐Bigas MA, et al. Colorectal carcinoma survival among hereditary nonpolyposis colorectal carcinoma family members. Cancer 1998;83:259–266.CrossRefPubMedGoogle Scholar
  62. 62.
    Park JG, Vasen HF, Park KJ, et al. Suspected hereditary nonpolyposis colorectal cancer: International Collaborative Group on Hereditary Non‐Polyposis Colorectal Cancer (ICG‐HNPCC) criteria and results of genetic diagnosis. Dis Colon Rectum 1999;42:710–715.CrossRefPubMedGoogle Scholar
  63. 63.
    Samowitz WS, Slattery ML, Kerber RA. Microsatellite instability in human colonic cancer is not a useful clinical indicator of familial colorectal cancer. Gastroenterology 1995;109:1765–1771.CrossRefPubMedGoogle Scholar
  64. 64.
    Vasen HF, van BM, Buskens E, et al. A cost‐effectiveness analysis of colorectal screening of hereditary nonpolyposis colorectal carcinoma gene carriers. Cancer 1998;82:1632–1637.CrossRefPubMedGoogle Scholar
  65. 65.
    Leppert M, Dobbs M, Scambler P, et al. The gene for familial polyposis coli maps to the long arm of chromosome 5. Science 1987;238:1411–1413.CrossRefPubMedGoogle Scholar
  66. 66.
    Arvanitis ML, Jagelman DG, Fazio VW, Lavery IC, McGannon E. Mortality in patients with familial adenomatous polyposis. Dis Colon Rectum 1990;33:639–642.CrossRefPubMedGoogle Scholar
  67. 67.
    Vasen HF, Griffioen G, Offerhaus GJ, et al. The value of screening and central registration of families with familial adenomatous polyposis. A study of 82 families in The Netherlands. Dis Colon Rectum 1990;33:227–230.CrossRefPubMedGoogle Scholar
  68. 68.
    Rustin RB, Jagelman DG, McGannon E, Fazio VW, Lavery IC, Weakley FL. Spontaneous mutation in familial adenomatous polyposis. Dis Colon Rectum 1990;33:52–55.CrossRefPubMedGoogle Scholar
  69. 69.
    Spirio L, Olschwang S, Groden J, et al. Alleles of the APC gene: an attenuated form of familial polyposis. Cell 1993;75:951–957.CrossRefPubMedGoogle Scholar
  70. 70.
    Giardiello FM, Brensinger JD, Petersen GM, et al. The use and interpretation of commercial APC gene testing for familial adenomatous polyposis. N Engl J Med 1997;336:823–827.CrossRefPubMedGoogle Scholar
  71. 71.
    Cromwell DM, Moore RD, Brensinger JD, Petersen GM, Bass EB, Giardiello FM. Cost analysis of alternative approaches to colorectal screening in familial adenomatous polyposis. Gastroenterology 1998;114:893–901.CrossRefPubMedGoogle Scholar
  72. 72.
    Marcello PW, Asbun HJ, Veidenheimer MC, et al. Gastroduodenal polyps in familial adenomatous polyposis. Surg Endosc 1996;10:418–421.CrossRefPubMedGoogle Scholar
  73. 73.
    Fireman Z, Grossman A, Lilos P, et al. Intestinal cancer in patients with Crohn's disease. A population study in central Israel. Scand J Gastroenterol 1989;24:346–350.CrossRefPubMedGoogle Scholar
  74. 74.
    Gollop JH, Phillips SF, Melton LD, Zinsmeister AR. Epidemiologic aspects of Crohn's disease: a population based study in Olmsted County, Minnesota, 1943–1982. Gut 1988;29:49–56.CrossRefPubMedGoogle Scholar
  75. 75.
    Kvist N, Jacobsen O, Norgaard P, et al. Malignancy in Crohn's disease. Scand J Gastroenterol 1986;21:82–86.CrossRefPubMedGoogle Scholar
  76. 76.
    Gyde SN, Prior P, Macartney JC, Thompson H, Waterhouse JA, Allan RN. Malignancy in Crohn's disease. Gut 1980;21: 1024–1029.CrossRefPubMedGoogle Scholar
  77. 77.
    Greenstein AJ, Sachar DB, Smith H, Janowitz HD, Aufses AJ. Patterns of neoplasia in Crohn's disease and ulcerative colitis. Cancer 1980;46:403–407.CrossRefPubMedGoogle Scholar
  78. 78.
    Weedon DD, Shorter RG, Ilstrup DM, Huizenga KA, Taylor WF. Crohn's disease and cancer. N Engl J Med 1973;289:1099–1103.CrossRefPubMedGoogle Scholar
  79. 79.
    Provenzale D, Kowdley KV, Arora S, Wong JB. Prophylactic colectomy or surveillance for chronic ulcerative colitis? A decision analysis. Gastroenterology 1995;109:1188–1196.CrossRefPubMedGoogle Scholar
  80. 80.
    Lennard JJ, Melville DM, Morson BC, Ritchie JK, Williams CB. Precancer and cancer in extensive ulcerative colitis: findings among 401 patients over 22 years. Gut 1990;31:800–806.CrossRefGoogle Scholar
  81. 81.
    Screening for colorectal cancer—United States, 1992–1993, and new guidelines. MMWR 1996;45:107–110.Google Scholar
  82. 82.
    Brown ML, Potosky AL, Thompson GB, Kessler LG. The knowledge and use of screening tests for colorectal and prostate cancer: data from the 1987 National Health Interview Survey. Prev Med 1990;19:562–574.CrossRefPubMedGoogle Scholar

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© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Thomas E. Read
  • Philip F. Caushaj

There are no affiliations available

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