Search

Since the invention of endoscopy in the 1800s, colonoscopy and flexible sigmoidoscopy have evolved into important tools in the diagnosis and treatment of lower gastrointestinal luminal diseases. These two modalities along with biochemical markers and widespread implementation of colorectal cancer (CRC) screening are responsible for the overall downtrend of CRC. However, this downward trend is not as robustly reflected in the right-sided CRC. It is thought that flat lesions in the right colon (sessile serrated polyp (SSA/P)), suboptimal colon preparation, differences in gender, and endoscopic techniques are some of the contributing factors accounting for this difference. In this review, we will summarize the most current literature and guidelines on CRC screening and surveillance. In addition, we will describe the recent advances in endoscopic CRC screening with emphasis on colonoscopy and flexible sigmoidoscopy and the changes they have brought to the CRC landscape in the US. [ABSTRACT FROM AUTHOR]

Purpose of Review: Up to 50% of patients with stage II or III colon cancer are estimated to develop locoregional recurrence, distant metastasis, or metachronous colon cancers within 5 years of initial treatment. Given the high risk of recurrence, surveillance is critical, but what is the optimal frequency and testing of surveillance, and is it possible to tailor surveillance plans based on risk prediction tools? Recent Findings: We reviewed the current national guidelines from 6 reputable oncologic organizations, as well as 10 randomized controlled trials and numerous meta-analyses in the last 22 years evaluating more intensive to less intensive surveillance to answer this question. Currently available adjunct testing, such as genomic testing, and risk calculators were also evaluated. Summary: Overall, high-frequency surveillance, to a limit, has been established as superior to less frequency surveillance. Future research will likely demonstrate evidence for adjunct testing for personalized surveillance screening based on individual recurrence risk. [ABSTRACT FROM AUTHOR]