Screening for colon and rectal cancer

This is a disease for which screening is important in those patients who have a positive family history of colorectal cancer (vide supra - causes section, especially Familial polyposis coli and HNPCC). A programme of serial fibreoptic colonoscopies and rectal exams needs to start in early adult or even late teenage life where there is such a familial predisposition.

 

Where there is no such familial predisposition, the routine use of faecal occult blood screening (the examination of three stool specimens by a smear test that picks up traces of blood mixed in with the stool)or colonoscopic exams (using a fibreoptic colonoscope) on a population basis is pracised without a very firm eevidence base (and the technique of 'virtual colonography' - a CT screeningtechnique - is becoming more popular).

 

However, patients with a past history of polyp(s) or cancer of the large bowel are at proven higher risk of a second such event and these patients should be on regular follow-up screening.