Colorectal Cancer Screening

Abstract

Colorectal cancer (CRC) is the second most common cancer in women and the third most common in men and is the third leading cause of all cancer deaths in the United States. Due to screening examinations used to detect and remove premalignant colon polyps, as well as modification of risk factors and improvements in the treatment of CRC, the incidence and mortality due to CRC have declined over the last several decades. Regardless, CRC continues to account for about 9% of all cancer deaths in the United States. This review addresses CRC, including the epidemiology, pathophysiology and genetics, screening modalities, treatment, and complications associated with CRC screening. Figures show etiologies of CRC, multiple sessile adenomas, a pedunculated adenoma, a sessile polyp, a large polyp found on computed tomographic colonography, and a characteristic sessile serrated adenoma/polyp with a mucus cap in the proximal colon. Tables list oncogenes, tumor suppressor genes, and mismatch repair genes involved in CRC; surveillance recommendations based on a family history of CRC; CRC risk stratification; CRC screening recommendations by risk stratification; and CRC surveillance recommendations. This review contains 6 highly rendered figures, 5 tables, and 82 references.