How good is screening for colorectal cancer?

Colorectal cancer is potentially preventable. Use of fecal occult blood testing, flexible sigmoidoscopy, and a combination of air-contrast barium enema examination and colonoscopy has proved to be a safe, relatively inexpensive approach to detecting colon cancer in its early stages, decreasing morbidity and increasing survival. Future work in secondary prevention of colon cancer should be aimed at standardized trials of fecal occult blood agents, thus optimizing the yield of localized lesions and decreasing the cost so that mass screening becomes possible. Major efforts should be aimed at educating physicians and the public alike. Primary prevention will deserve greater emphasis when specific risk factors pathogenetic of colon cancer are discovered.