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Gastroenterology. 2019 Aug 5. pii: S0016-5085(19)41185-2. doi: 10.1053/j.gastro.2019.06.043. [Epub ahead of print]

Strategies for Colorectal Cancer Screening.

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Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA. Electronic address:
Gastroenterology Section, VA Puget Sound Health Care System, Seattle, Washington, Division of Gastroenterology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington.
Indiana University School of Medicine and Richard L. Roudebush VA Medical Center, Indianapolis, IN.
Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh, Pittsburgh, PA.


The incidence of colorectal cancer (CRC) is increasing worldwide. CRC has high mortality when detected at advanced stages, yet it is also highly preventable. Given the difficulties in implementing major lifestyle changes or widespread primary prevention strategies to decrease CRC risk, screening is the most powerful public health tool to reduce mortality. Screening methods are effective but have limitations. Furthermore, many screen-eligible persons remain unscreened. We discuss established and emerging screening methods, and potential strategies to address current limitations in CRC screening. A quantum step in CRC prevention might come with the development of new screening strategies, but great gains can be made by deploying the available CRC screening modalities in ways that optimize outcomes while making judicious use of resources.


colonoscopy; fecal immunochemical test; fecal occult blood test; sigmoidoscopy

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