Colorectal Cancer Screening: America's Next Top Model?
Authors: David S. Weinberg, Robert E. Schoen
Journal: Annals of Internal Medicine (2012)

Editorials6 November 2012Colorectal Cancer Screening: America's Next Top Model?David S. Weinberg, MD, MSc and Robert E. Schoen, MD, MPHDavid S. Weinberg, MD, MScFrom Fox Chase Cancer Center, Philadelphia, PA 19111; and University of Pittsburgh Medical Center, Pittsburgh, PA 15213.Search for more papers by this author and Robert E. Schoen, MD, MPHFrom Fox Chase Cancer Center, Philadelphia, PA 19111; and University of Pittsburgh Medical Center, Pittsburgh, PA 15213.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-9-201211060-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The prevention and early detection of colorectal cancer (CRC) is a modern public health success story. Randomized CRC screening trials of fecal occult blood testing (FOBT) and flexible sigmoidoscopy have demonstrated significant reductions in CRC incidence and mortality (1–3). Colorectal cancer screening has garnered a grade A recommendation from the U.S. Preventive Services Task Force (4).Alternative methods for screening are emerging. What began with FOBT and flexible sigmoidoscopy now includes colonoscopy, fecal immunochemical testing (FIT), computed tomography (CT) colonography, and stool DNA testing. Compared with no screening, all of these options are likely to be effective. However, studies comparing ...References1. Levin B, Lieberman DA, McFarland B, Andrews KS, Brooks D, Bond J, et al; American Cancer Society Colorectal Cancer Advisory Group. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology. 2008;134:1570-95. [PMID: 18384785] CrossrefMedlineGoogle Scholar2. Atkin WS, Edwards R, Kralj-Hans I, Wooldrage K, Hart AR, Northover JM, et al; UK Flexible Sigmoidoscopy Trial Investigators. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet. 2010;375:1624-33. [PMID: 20430429] CrossrefMedlineGoogle Scholar3. Schoen RE, Pinsky PF, Weissfeld JL, Yokochi LA, Church T, Laiyemo AO, et al; PLCO Project Team. Colorectal-cancer incidence and mortality with screening flexible sigmoidoscopy. N Engl J Med. 2012;366:2345-57. [PMID: 22612596] CrossrefMedlineGoogle Scholar4. Whitlock EP, Lin JS, Liles E, Beil TL, Fu R. Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2008;149:638-58. [PMID: 18838718] LinkGoogle Scholar5. Lieberman DA, Weiss DG, Bond JH, Ahnen DJ, Garewal H, Chejfec G. Use of colonoscopy to screen asymptomatic adults for colorectal cancer. Veterans Affairs Cooperative Study Group 380. N Engl J Med. 2000;343:162-8. [PMID: 10900274] CrossrefMedlineGoogle Scholar6. Penn E, Garrow D, Romagnuolo J. Influence of race and sex on prevalence and recurrence of colon polyps. Arch Intern Med. 2010;170:1127-32. [PMID: 20625018] CrossrefMedlineGoogle Scholar7. Knudsen AB, Hur C, Gazelle GS, Schrag D, McFarland EG, Kuntz KM. Rescreening of persons with a negative colonoscopy result: results from a microsimulation model. Ann Intern Med. 2012;157:611-20. LinkGoogle Scholar8. Quintero E, Castells A, Bujanda L, Cubiella J, Salas D, Lanas Á, et al; COLONPREV Study Investigators. Colonoscopy versus fecal immunochemical testing in colorectal-cancer screening. N Engl J Med. 2012;366:697-706. [PMID: 22356323] CrossrefMedlineGoogle Scholar9. Inadomi JM, Vijan S, Janz NK, Fagerlin A, Thomas JP, Lin YV, et al. Adherence to colorectal cancer screening: a randomized clinical trial of competing strategies. Arch Intern Med. 2012;172:575-82. [PMID: 22493463] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: David S. Weinberg, MD, MSc; Robert E. Schoen, MD, MPHAffiliations: From Fox Chase Cancer Center, Philadelphia, PA 19111; and University of Pittsburgh Medical Center, Pittsburgh, PA 15213.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-2358.Corresponding Author: David S. Weinberg, MD, MSc, Department of Medicine, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111; e-mail, [email protected].Current Author Addresses: Dr. Weinberg: Department of Medicine, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111.Dr. Schoen: University of Pittsburgh Medical Center,200 Lothrop Street, Mezzanine Level, C Wing, PUH, Pittsburgh, PA 15213. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRescreening of Persons With a Negative Colonoscopy Result: Results From a Microsimulation Model Amy B. Knudsen , Chin Hur , G. Scott Gazelle , Deborah Schrag , Elizabeth G. McFarland , and Karen M. Kuntz Metrics Cited byAssociation Between Endoscopist Personality and Rate of Adenoma Detection 6 November 2012Volume 157, Issue 9Page: 673-674KeywordsAdenomasCancer screeningColonoscopyColorectal cancer screeningComputed axial tomographySurvival analysis ePublished: 6 November 2012 Issue Published: 6 November 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...