Colorectal Cancer Screening.

Colorectal cancer (CRC) remains the second leading cause of cancer death in the United States (1). It is estimated that approx 148,610 will be diagnosed with CRC and 55,170 will die from it in 2006 (1). However, mortality from CRC has been declining over the past 20 yr, felt largely to be due to earlier detection. The average lifetime risk is 6%, with men and women almost equally affected. Most cases are sporadic, apparently resulting from a combination of environmental and genetic factors (Fig. 1), although there are many known risk factors (Table 1). Screening for CRC has been advocated on the grounds that CRC is a major public health problem, it is preventable through removal of precursor lesions, it is curable if detected early (Fig. 2), and screening tests have been proven to impact disease outcomes. In fact, some screening strategies have been proven to reduce cancer mortality and many strategies are cost-effective (2,3). Unfortunately, CRC screening is under-utilized because of a variety of barriers to screening. [ABSTRACT FROM AUTHOR]