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Special Review |
1 From the Department of Radiology, Decision Analysis and Technology Assessment Group, Zero Emerson Pl, Suite 2H, Boston, MA 02114 (G.S.G., P.M.M.) and the Lahey Clinic Foundation, Burlington, Mass (F.J.S.). Received July 1, 1999; revision requested August 9; revision received October 11; accepted November 18. Address correspondance to G.S.G. (e-mail: gazelle@nmr.mgh.harvard.edu).
Abstract
Colorectal cancer is the third most commonly diagnosed cancer and the second leading cause of cancer deaths in the United States. Fortunately, both the incidence and mortality associated with the disease have declined during the past 2 decades. This is likely due, at least in part, to improved efforts at screening and more aggressive removal of adenomatous polyps. However, colorectal cancer screening is still generally underutilized. This article reviews the current status and future outlook for colorectal cancer screening, including a discussion of risk factors for the disease, its anatomic distribution, proposed mechanisms of development from adenomatous polyps, rationale for screening, and screening options. Published literature concerning the cost-effectiveness of colorectal cancer screening is also summarized. The article concludes with a discussion of the emerging consensus regarding the importance of and approaches to screening.
Index terms: Barium enema examination, 75.128 • Cancer screening, 75.128, 75.129, 75.321 • Colon, neoplasms, 75.128, 75.129, 75.321 • Colonoscopy, 75.129 • Cost-effectiveness • Review
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