Colorectal cancer: does early detection matter?

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Abstract
The survival from colorectal cancer is related directly to the degree of malignant invasion through the bowel wall that has occurred by the time of diagnosis and treatment. Only about 50% of all patients, symptomatic at the time of their diagnosis, will be alive five years after treatment (surgery and oncological treatment). In contrast, all three large scale population randomised trials of faecal occult blood screening, in the UK, USA and Scandinavia, have demonstrated a significant reduction of 15%–30% in mortality caused by colorectal cancer.1-3 This increased survival was due to detecting more asymptomatic persons with early stage, less invasive, and therefore a surgically curable disease. Each study used a slightly different screening protocol (annual or biennial screening, or by using non-hydrated or rehydrated faecal occult blood tests); even so, all these studies demonstrated the benefit of screening. Suffice it to say, that since then, there have been further refinements of the faecal occult blood test screening methodology, which can only increase the medical benefits.4