Colorectal Cancer Screening

Population-based studies have shown that guaiac faecal occult blood testing followed by colonoscopy in case of positivity can reduce colorectal cancer (CRC) mortality. However, these tests have been criticized in particular for their low sensitivity. For this reason, attention has been given for alternative tests such as immunochemical faecal occult blood tests. Automated system can determine the concentration of human haemoglobin in faeces samples. It is now clear from available data that immunochemical tests outperform guaiac tests. They should be preferred for CRC screening. They will be available in France early 2015. The one-sample strategy has now been adopted in most screening programmes. Given the superior performance characteristics of immunochemical tests (they allow the detection of CRC to be doubled and a 3-4 fold increase in the detection rate of advanced adenoma as well as higher participation), it is reasonable to assume that an organized programme using this type of test would lead to a greater reduction in CRC mortality and possibly of CRC incidence.