Colorectal cancer screening.

Colorectal Cancer

Colorectal cancer is an increasingly common and significant global issue. In Thailand, it ranks third among males and fifth among females. Risk increases after age 50, and one in three patients may have a family history. Increased biological understanding leads to early prevention through screening, improving survival rates over the past decade. For screening, several methods exist, each with pros and cons. One common method is the Fecal Occult Blood Test (FOBT), widely used in Europe and the U.S. It has a 1-2.6% positive result, indicating a chance of colorectal cancer. However, this method's limitations include low sensitivity, high false positives, and dietary restrictions, making it inconvenient for many patients.

Colorectal examination can be done in several ways, such as:

Double-Contrast Barium Enema (DCBE): Utilizing barium enema inserted through the rectum, this method is not definitively effective and requires experienced physicians.

Colonoscopy: The most effective method, it can reduce the incidence of colorectal cancer but is expensive.

CT Colonography: Using Helical CT, this method is quick and safe but not highly sensitive or specific.

Fecal DNA Testing: More sensitive than FOBT by up to 4 times, it may be a tool for screening in the future.

The general limitations of colorectal examination are differing sensitivity and specificity, costs, and the comfort of the examinee. The choice of examination method for each individual should be considered from various factors.

With best wishes from, Gastrointestinal System Center, Vibhavadi Hospital