ADICON Clinical LaboratoryADICON Clinical Laboratory

news

Colorectal cancer screening: an interview with Dr Donato F. Altomare 1

Please can you give a brief introduction to colorectal cancer?

Colorectal cancer is a malignant neoplasm affecting the large bowel and the rectum mainly after the 5th decade of life and representing the second cause of death for cancer in western countries (the third in women). In about 15-20% of patients there is an inherited predisposition.

Despite major improvement in diagnosis and treatment achieved in the last decades, still a large proportion of these patients are treated in an advanced stage of the disease when the curative managements are impossible.

Nevertheless this type of cancer could be prevented or at least diagnosed in its early stage because most of the cancers originate from the slow malignant transformation of colonic polyps which could be easily removed by endoscopy. Recent studies have confirmed that patients in whom this cancer was discovered because of a screening test have better prognosis compared to patients with symptomatic disease

What screening procedure is currently used for colorectal cancer?

Since this cancer and its benign precursor (polyp)can release a minimal quantity of blood, an immunochemical test looking to occult traces of blood in the feces is the method of screening usually employed as a mass screening tool (the FOBT).

However this test has several drawback including a scarce patients compliance and a low accuracy leading to an unacceptable high proportion of useless colonoscopy (which are expensive, risky and bad tolerated by the patients) and of missing cancers or polyps.