Publication Type
Journal Article
UWI Author(s)
Author, Analytic
Lee, M.G.
Author Affiliation, Ana.
Department of Medicine
Article Title
Colon cancer screening
Medium Designator
Connective Phrase
Journal Title
West Indian Medical Journal
Translated Title
Reprint Status
Date of Publication
Volume ID
Issue ID
Connective Phrase
0043-3144 WIMJAD
Colorectal cancer (CRC) is a common clinical problem which is increasing in Jamaica. It is the second highest cause of cancer mortality in most developed countries (1). In Jamaica, CRC is the third commonest cancer in both males and females (2). Colorectal cancer is preventable. The majority of such cancers arise from benign adenomatous polyps and in most cases it takes about ten years for a small adenomatous polyp to progress and transform to advanced CRC. Evidence indicates that significant reduction in CRC mortality can be achieved by screening (3,4). The objective of screening is to detect and treat precursor lesions and early stage cancer. However, the strategy and recommendations as to the best method of screening has been debated over the past decade. In general, screening can only be recommend if the following criteria are fulfilled. Firstly, the disease has to be a common problem with public health implications. Secondly, there must be widely available and effective theraphy for the disease, and detection and treatment of precursor lesions and early disease must significantly decrease the prevalence and mortality of the disease. Thirdly, there should be an effective, non-invasive and relatively cheap screening method available which is acceptable to all. The first two criteria are fulfilled with regards with to CRC. The major problem is to decide on which of the various options available should be used and the best strategy for screening for CRC. There are several tests available. These include faecal occult blood testing (FOBT), flexible sigmoidoscopy (F?S), barium enema and colonoscopy. Recently, computed tomography colonography (CTC) has been introduced but, at present, the position of this technique in screening for CRC remains unclear (3, 5-8). Screening for CRC is divided into two risk categories: high risk and average risk. Patients at high risk include those with a personal history of adenomatous polyps and CRC. Individuals with a first degree relative with CRC, especially if the tumour developed below age 60 years, are at increased risk. Those with a family history of familial polyposis coli and non-polyposis colon cancer are at high risk should be followed and have evaluation of the colon, preferably colonoscopy, at intervals. Individuals without any of the above risk factors are at average risk. In these individuals, the risk for developing CRC increases with age and increases significantly after age 50 years.....
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