Screening for Colon Cancer — Can We Afford Colonoscopy?

Over the past 20 years, much has been learned about screening for colon cancer from biologic, epidemiologic, and clinical studies. 1 Colorectal cancer is a leading cause of death in the Western world, but survival can be improved if the disease is detected early. Precursor lesions (polyps) almost always precede the development of the neoplasm by several years, and removing polyps may reduce the risk of cancer. A variety of screening techniques can detect premalignant lesions and early-stage cancers. Four large-scale, randomized trials have shown that annual or biennial screening of people without symptoms by means of fecal occult-blood testing reduces . . .