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Review
. 2017 Jul 28;23(28):5086-5096.
doi: 10.3748/wjg.v23.i28.5086.

Colorectal cancer screening: An updated review of the available options

Iyad A Issa  1 , Malak Noureddine  1
Affiliations
Review

Colorectal cancer screening: An updated review of the available options

Iyad A Issa et al. World J Gastroenterol. .

Abstract

Colorectal cancer (CRC) is a significant cause of morbidity and mortality worldwide. However, colon cancer incidence and mortality is declining over the past decade owing to adoption of effective screening programs. Nevertheless, in some parts of the world, CRC incidence and mortality remain on the rise, likely due to factors including "westernized" diet, lifestyle, and lack of health-care infrastructure and resources. Participation and adherence to different national screening programs remain obstacles limiting the achievement of screening goals. Different modalities are available ranging from stool based tests to radiology and endoscopy with varying sensitivity and specificity. However, the availability of these tests is limited to areas with high economic resources. Recently, FDA approved a blood-based test (Epi procolon®) for CRC screening. This blood based test may serve to increase the participation and adherence rates. Hence, leading to increase in colon cancer detection and prevention. This article will discuss various CRC screening tests with a particular focus on the data regarding the new approved blood test. Finally, we will propose an algorithm for a simple cost-effective CRC screening program.

Keywords: Blood DNA test; Colonoscopy; Colorectal cancer; Fecal DNA test; Guidelines; Occult blood; Screening.

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Conflict of interest statement

Conflict-of-interest statement: No potential conflicts of interest.

Figures

Figure 1
Figure 1
SEPT9 gene. Septins: Multifunctional “scaffolding” proteins that provide structural support during cytokinesis. SEPT9 gene produces septin-9 that appears to act as a tumor suppressor which is active in cells throughout body. In CRC cells: SEPT9 gene is hypermethylated and the DNA is released into peripheral blood. Methylated SEPT9 DNA can be detected by PCR 34.
Figure 2
Figure 2
Proposed algorithm for a cost-effective screening program. FIT: Fecal immunochemical test.
See this image and copyright information in PMC

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