Invited Commentary

Fecal Occult Blood Testing: Where Do We Stand?

Authors: Patrick Brady, MD

Abstract

Colorectal cancer (CRC) is the third most common cancer and the third leading cause of cancer death in the United States. The incidence of new cases of CRC is estimated to be 103,170, and approximately 51,000 of these cases will die in 2012, despite the fact that both the incidence and mortality of this disease are declining.1,2Most CRCs develop from preexisting adenomatous polyps that can develop progressive genetic abnormalities, resulting in dysplasia and eventually carcinoma during a period of years. Larger adenomas and those with high-grade dysplasia or villous changes (advanced adenomas) have a greater risk of progressing to colon cancer. This challenge is an opportunity to prevent CRC by finding and removing adenomatous polyps, particularly advanced adenomas. The current goals of screening for CRC include detecting cancer at an early, curable stage and preventing colon cancer by identifying and removing the benign, typically asymptomatic precursor lesions (adenomatous polyps).

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