Cost-effectiveness of Screening for Colorectal Cancer in the General Population

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Abstract
Colorectal cancer (CRC) is the second leading cause of cancer-related mortality in the United States, resulting in approximately 56,600 deaths in 1999.1 Screening for CRC reduces mortality through detection of malignancy at an earlier, more treatable stage as well as by identification and removal of the precursor lesion, the adenomatous polyp. A recent panel recommended that average-risk individuals begin screening at the age of 50 years with one of the following strategies: annual fecal occult blood testing (FOBT), flexible sigmoidoscopy (SIG) every 5 years, annual FOBT plus SIG every 5 years, double-contrast barium enema (DCBE) every 5 to 10 years, or colonoscopy (COL) every 10 years.2