Early Diagnosis of Colorectal Cancer

Abstract

Screening of asymptomatic patients at risk is potentially the most effective means for detecting early colorectal carcinoma. Sensitive and specific tests are available for this purpose. However, an aggressive approach by the physician and compliance by the patient population are necessary for the proper implementation of this screening process.

Early Detection of Cancer: An Overview

“…Risk indicators of colorectal cancer include age, associated disease such as ulcerative colitis and Crohn's Disease, past history of colorectal adenoma, colorectal cancer, genital or breast cancer in women, family history of polyposis syndromes, and colorectal carcinoma and adenoma (43,109). Potentially modifiable risk factors for colorectal cancer may include high dietary intake of meat and fat and low consumption of fiber and cruciferous vegetables (15,36,96).…”

“…However, there is no evidence so far to suggest that intervening on these risk factors would alter the mortality experience from colorectal cancer in the population. Survival following surgery for colorectal cancer has not significantly changed over the past 40 years, the overall five-year survival rates varying between 40 and 45% (43,104 detection has been proposed as an alternative approach to this public health problem. Three methods have been suggested for early detection of colorectal cancer: digital rectal examination, rigid sigmoidoscopy and its more recent clones including flexible sigmoidoscopy and colonoscopy, and testing for occult blood in stools.…”

“…Specificity, on the other hand, remains con sistently high, 97 to 99%. However, because the prevalence of cancers detected is low, the predictive value of a positive Hemoccult test for col orectal cancer can range from 12% (3) to 18-50% (43). If either cancer or polyps are screened then the sensitivity can drop from 67% to 58%, with a positive predictive value ranging from 37% to 51 % (3).…”

The pros and cons of fecal occult blood testing for colorectal neoplasms

“…Such individuals include those with previous colonic carcinoma, benign neoplastic polyps, a family history of bowel cancer, previous breast or pelvic malignancy, or prior ureterosigmoidostomy [98,104]. Although such patients comprise only about 12%-15% of the overall population with colorectal cancer [104], their enhanccd individual risk justifies special concern.…”

Lipocalin 2 Level Predicts Prognostic Outcome in Patients with Colorectal Cancer Undergoing Surgical Intervention

“…The long-term prognostic outcome of CRC is usually favorable if there is early diagnosis and treatment [4,5]. On the other hand CRC cases diagnosed at an advanced stage result in a high mortality rate because of the relatively asymptomatic nature of early-stage disease and lack of adequate screening tests [1,6,7].…”