Precision Screening for Colorectal Cancer: Promise and Challenges
Authors: Chyke A. Doubeni
Journal: Annals of Internal Medicine (2015)

Editorials1 September 2015Precision Screening for Colorectal Cancer: Promise and ChallengesChyke A. Doubeni, MD, MPHChyke A. Doubeni, MD, MPHFrom University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-1677 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Screening is the most effective public health intervention for colorectal cancer. Increasing uptake of screening in the United States over the past 3 to 4 decades has led to decreasing disease incidence and mortality (1). Because screening is done on clinically asymptomatic persons, those who are biologically at low disease risk mostly incur the costs and harms, whereas those at higher risk may derive more benefit than harm from prevention or early detection. Current colorectal cancer screening recommendations are based on 4 risk groups: patients with familial adenomatous polyposis, the Lynch syndrome, or other inheritable disorders known or suspected to ...References1. Edwards BK, Ward E, Kohler BA, Eheman C, Zauber AG, Anderson RN, et al. Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer. 2010;116:544-73. [PMID: 19998273] doi:10.1002/cncr.24760 CrossrefMedlineGoogle Scholar2. Vogelstein B, Fearon ER, Hamilton SR, Kern SE, Preisinger AC, Leppert M, et al. Genetic alterations during colorectal-tumor development. N Engl J Med. 1988;319:525-32. [PMID: 2841597] CrossrefMedlineGoogle Scholar3. Zauber AG, Lansdorp-Vogelaar I, Knudsen AB, Wilschut J, van Ballegooijen M, Kuntz KM. 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Multitarget stool DNA testing for colorectal-cancer screening. N Engl J Med. 2014;370:1287-97. [PMID: 24645800] doi:10.1056/NEJMoa1311194 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Chyke A. Doubeni, MD, MPHAffiliations: From University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-1677.Corresponding Author: Chyke A. Doubeni, MD, MPH, Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, 2nd Floor Gates Pavilion, 3400 Spruce Street, Philadelphia, PA 19104; e-mail, chyke.doubeni@uphs.upenn.edu.This article was published online first at www.annals.org on 11 August 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDerivation and Validation of a Scoring System to Stratify Risk for Advanced Colorectal Neoplasia in Asymptomatic Adults Thomas F. Imperiale , Patrick O. Monahan , Timothy E. Stump , Elizabeth A. Glowinski , and David F. 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