Colorectal Cancer Screening and Surveillance for Non-Hereditary High-Risk Groups —Is It Time for a Re-Think?

AbstractPurpose of reviewColorectal cancer (CRC) is the second most common cause of cancer death worldwide, killing approximately 900,000 people each year. An individual ’s risk of developing CRC is multi-factorial with known risk factors including increasing age, male sex, family history of CRC and raised body mass index. Population-based screening programmes for CRC exist in many countries, and in the United Kingdom (UK), screening is performed through the NHS B owel Cancer Screening Programme (BCSP). Screening programmes offer a population-based approach for those at “average risk”, and do not typically offer enhanced screening for groups at increased risk. In the UK, such patients are managed via non-screening symptomatic services but in a non-systema tic way.Recent findingsThere is growing evidence that conditions such as cystic fibrosis and a history of childhood cancer are associated with higher risk of CRC, and surveillance of these groups is advocated by some organizations; however, national recommendations do not exist in most countries.SummaryWe review the evidence for screening “high risk” groups not covered within most guidelines and discuss health economic issues requiring consideration acknowledging that the demand on colonoscopy services is already overwhelming.

Source: Current Treatment Options in Gastroenterology - January 5, 2021 Category: Gastroenterology Source Type: research