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Annals of Oncology 13:40-43, 2002
© 2002 European Society for Medical Oncology

Debate

Fecal occult blood testing as a screening procedure for colorectal cancer

A. B. Lowenfels,+

Department of Surgery, New York Medical College, Valhalla, NY, USA and Division of Epidemiology and Biostatistics, European Institute of Oncology Milan, Italy

Received 9 August 2001; accepted 10 October 2001.

Key words: colorectal cancer, fecal occult blood, screening

Introduction

With an estimated life-time cumulative incidence of around 5%, and an overall long-term mortality of about 40% to 50%, colorectal cancer (CRC) adds greatly to the burden of cancer for both patients and health providers. We now know that nearly all CRC arises from pre-existing polyps, implying that detection and removal of these premalignant lesions would have an enormous impact on CRC.

In high-risk countries, incidence and mortality rates have demonstrated only minor changes during the past decade, raising the question: ‘why don’t we screen for this potentially preventable cancer?’ Table 1 lists some basic background information concerning fecal occult blood testing (FOBT).


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  		Table 1. Basic considerations for fecal occult blood testing in persons with colorectal cancer (CRC)
 
For several decades, FOBT has been available to detect and thereby potentially reduce the frequency of this prevalent cancer. The test is safe, inexpensive, and can be performed without sophisticated equipment. FOBT detects tumors . . . [Full Text of this Article]

Does FOBT reduce the burden of colorectal cancer?

Should we recommend wide-scale FOBT for the general population

Other available screening tests

Flexible sigmoidoscopy
Colonoscopy
Radiological procedures
DNA stool examination
Conclusions

Footnotes

References


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