Colorectal cancer screening

Abstract

Colorectal cancer is the third most common cancer, and the second leading cause of cancer death in the UK, with 35,000 diagnoses and 16,000 deaths per year. It costs the National Health Service (NHS) expenditure of more than £300 million pounds in surgical, adjuvant and palliative treatment. The disease is uniquely placed for screening strategies, as 70–90% of the tumours arise from premalignant, adenomatous polyps. This transformation may take 10 years or more and provides us with a window of opportunity to detect early tumours (Dukes' A) and also prevent cancer development by excision and removal of premalignant polyps during colonoscopy. The NHS Bowel Screening Programme in the UK is based on the principle of secondary prevention whereby detection and treatment of existing preneoplastic and early neoplastic lesions would result in reduction of prevalence and improvement in survival of patients with colorectal cancer.