Colorectal Cancer Screening: Is Colonoscopy the Best Option?

Med Clin North Am. 2019 Jan;103(1):111-123. doi: 10.1016/j.mcna.2018.08.010. Epub 2018 Nov 1.

Abstract

Colorectal cancer is the second leading cause of cancer death in the United States. Prospective studies demonstrate that colorectal cancer screening reduces incidence and mortality, but uptake remains suboptimal. More than a third of age-eligible Americans are not up to date on screening. There are several available screening tests, which may cause primary care providers to ponder which is the best test. This article provides an overview of the available test options and the evidence for each; a summary of major guidelines; and a comparison of the two most widely used tests, colonoscopy and fecal immunochemical testing.

Keywords: Colonoscopy; Colorectal cancer; Effectiveness; Fecal immunochemical test; Fecal occult blood test; Guidelines; Screening; Sigmoidoscopy.

Publication types

  • Review

MeSH terms

  • Colonography, Computed Tomographic / methods
  • Colonoscopy / methods*
  • Colorectal Neoplasms / diagnosis*
  • Early Detection of Cancer / methods*
  • Feces
  • Humans
  • Occult Blood
  • Practice Guidelines as Topic