Mortality from colorectal cancer can be reduced by early diagnosis and by cancer prevention through polypectomy. These NCCN Guidelines for Colorectal Cancer Screening describe various colorectal screening modalities and recommended screening schedules for patients at average or increased risk of developing colorectal cancer. In addition, the guidelines provide recommendations for the management of patients with high-risk colorectal cancer syndromes, including Lynch syndrome. Screening approaches for Lynch syndrome are also described.

  • 1.

    SiegelRNaishadhamDJemalA. Cancer statistics, 2013. CA Cancer J Clin2013;63:1130.

  • 2.

    ChengLEngCNiemanLZ. Trends in colorectal cancer incidence by anatomic site and disease stage in the United States from 1976 to 2005. Am J Clin Oncol2011;34:573580.

    • Search Google Scholar
    • Export Citation
  • 3.

    EhemanCHenleySJBallard-BarbashR. Annual report to the nation on the status of cancer, 1975-2008, featuring cancers associated with excess weight and lack of sufficient physical activity. Cancer2012;118:23382366.

    • Search Google Scholar
    • Export Citation
  • 4.

    SiegelRWardEBrawleyOJemalA. Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin2011;61:212236.

    • Search Google Scholar
    • Export Citation
  • 5.

    GundersonLLJessupJMSargentDJ. Revised TN categorization for colon cancer based on national survival outcomes data. J Clin Oncol2010;28:264271.

    • Search Google Scholar
    • Export Citation
  • 6.

    BurtRNeklasonDW. Genetic testing for inherited colon cancer. Gastroenterology2005;128:16961716.

  • 7.

    GiardielloFMOfferhausJG. Phenotype and cancer risk of various polyposis syndromes. Eur J Cancer1995;31A:10851087.

  • 8.

    HamiltonSRLiuBParsonsRE. The molecular basis of Turcot’s syndrome. N Engl J Med1995;332:839847.

  • 9.

    LevinBLiebermanDAMcFarlandB. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin2008;58:130160.

    • Search Google Scholar
    • Export Citation
  • 10.

    RexDKJohnsonDAAndersonJC. American College of Gastroenterology guidelines for colorectal cancer screening 2009 [corrected]. Am J Gastroenterol2009;104:739750.

    • Search Google Scholar
    • Export Citation
  • 11.

    U.S. Preventive Services Task Force. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med2008;149:627637.

    • Search Google Scholar
    • Export Citation
  • 12.

    Centers for Disease Control and Prevention (CDC). Cancer screening - United States, 2010. MMWR Morb Mortal Wkly Rep2012;61:4145.

  • 13.

    BurtRW. Colorectal cancer screening. Curr Opin Gastroenterol2010;26:466470.

  • 14.

    WarrenJLKlabundeCNMariottoAB. Adverse events after outpatient colonoscopy in the Medicare population. Ann Intern Med2009;150:849857W152.

    • Search Google Scholar
    • Export Citation
  • 15.

    CitardaFTomaselliGCapocacciaR. Efficacy in standard clinical practice of colonoscopic polypectomy in reducing colorectal cancer incidence. Gut2001;48:812815.

    • Search Google Scholar
    • Export Citation
  • 16.

    JacobBJMoineddinRSutradharR. Effect of colonoscopy on colorectal cancer incidence and mortality: an instrumental variable analysis. Gastrointest Endosc2012;76:355364e351.

    • Search Google Scholar
    • Export Citation
  • 17.

    WinawerSJZauberAGHoMN. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med1993;329:19771981.

    • Search Google Scholar
    • Export Citation
  • 18.

    ManserCNBachmannLMBrunnerJ. Colonoscopy screening markedly reduces the occurrence of colon carcinomas and carcinoma-related death: a closed cohort study. Gastrointest Endosc2012;76:110117.

    • Search Google Scholar
    • Export Citation
  • 19.

    MullerADSonnenbergA. Prevention of colorectal cancer by flexible endoscopy and polypectomy. A case-control study of 32,702 veterans. Ann Intern Med1995;123:904910.

    • Search Google Scholar
    • Export Citation
  • 20.

    RabeneckLPaszatLFSaskinRStukelTA. Association between colonoscopy rates and colorectal cancer mortality. Am J Gastroenterol2010;105:16271632.

    • Search Google Scholar
    • Export Citation
  • 21.

    BaxterNNGoldwasserMAPaszatLF. Association of colonoscopy and death from colorectal cancer. Ann Intern Med2009;150:18.

  • 22.

    BarclayRLVicariJJDoughtyAS. Colonoscopic withdrawal times and adenoma detection during screening colonoscopy. N Engl J Med2006;355:25332541.

    • Search Google Scholar
    • Export Citation
  • 23.

    RadaelliFMeucciGSgroiGMinoliG. Technical performance of colonoscopy: the key role of sedation/analgesia and other quality indicators. Am J Gastroenterol2008;103:11221130.

    • Search Google Scholar
    • Export Citation
  • 24.

    KahiCJImperialeTFJuliarBERexDK. Effect of screening colonoscopy on colorectal cancer incidence and mortality. Clin Gastroenterol Hepatol2009;7:770775; quiz 711.

    • Search Google Scholar
    • Export Citation
  • 25.

    ZauberAGWinawerSJO’BrienMJ. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med2012;366:687696.

    • Search Google Scholar
    • Export Citation
  • 26.

    BrennerHChang-ClaudeJSeilerCM. Protection from colorectal cancer after colonoscopy: a population-based, case-control study. Ann Intern Med2011;154:2230.

    • Search Google Scholar
    • Export Citation
  • 27.

    BaxterNNWarrenJLBarrettMJ. Association between colonoscopy and colorectal cancer mortality in a US cohort according to site of cancer and colonoscopist specialty. J Clin Oncol2012;30:26642669.

    • Search Google Scholar
    • Export Citation
  • 28.

    QuinteroECastellsABujandaL. Colonoscopy versus fecal immunochemical testing in colorectal-cancer screening. N Engl J Med2012;366:697706.

    • Search Google Scholar
    • Export Citation
  • 29.

    HassanCGiorgi RossiPCamilloniL. Meta-analysis: adherence to colorectal cancer screening and the detection rate for advanced neoplasia, according to the type of screening test. Aliment Pharmacol Ther2012;36:929940.

    • Search Google Scholar
    • Export Citation
  • 30.

    KaminskiMFRegulaJKraszewskaE. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med2010;362:17951803.

  • 31.

    LiebermanDNadelMSmithRA. Standardized colonoscopy reporting and data system: report of the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. Gastrointest Endosc2007;65:757766.

    • Search Google Scholar
    • Export Citation
  • 32.

    RexDKCummingsOWHelperDJ. 5-year incidence of adenomas after negative colonoscopy in asymptomatic average-risk persons [see comment]. Gastroenterology1996;111:11781181.

    • Search Google Scholar
    • Export Citation
  • 33.

    ImperialeTFGlowinskiEALin-CooperC. Five-year risk of colorectal neoplasia after negative screening colonoscopy. N Engl J Med2008;359:12181224.

    • Search Google Scholar
    • Export Citation
  • 34.

    LiebermanDAWeissDGHarfordWV. Five-year colon surveillance after screening colonoscopy. Gastroenterology2007;133:10771085.

  • 35.

    SinghHTurnerDXueL. Risk of developing colorectal cancer following a negative colonoscopy examination: evidence for a 10-year interval between colonoscopies. JAMA2006;295:23662373.

    • Search Google Scholar
    • Export Citation
  • 36.

    BrennerHChang-ClaudeJSeilerCM. Does a negative screening colonoscopy ever need to be repeated?Gut2006;55:11451150.

  • 37.

    BrennerHChang-ClaudeJSeilerCMHoffmeisterM. Long-term risk of colorectal cancer after negative colonoscopy. J Clin Oncol2011;29:37613767.

    • Search Google Scholar
    • Export Citation
  • 38.

    NewcombPANorfleetRGStorerBE. Screening sigmoidoscopy and colorectal cancer mortality. J Natl Cancer Inst1992;84:15721575.

  • 39.

    AtkinWSEdwardsRKralj-HansI. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet2010;375:16241633.

    • Search Google Scholar
    • Export Citation
  • 40.

    SegnanNArmaroliPBonelliL. Once-only sigmoidoscopy in colorectal cancer screening: follow-up findings of the Italian Randomized Controlled Trial--SCORE. J Natl Cancer Inst2011;103:13101322.

    • Search Google Scholar
    • Export Citation
  • 41.

    HoffGGrotmolTSkovlundEBretthauerM. Risk of colorectal cancer seven years after flexible sigmoidoscopy screening: randomised controlled trial. BMJ2009;338:b1846.

    • Search Google Scholar
    • Export Citation
  • 42.

    SchoenREPinskyPFWeissfeldJL. Colorectal-cancer incidence and mortality with screening flexible sigmoidoscopy. N Engl J Med2012;366:23452357.

    • Search Google Scholar
    • Export Citation
  • 43.

    WeissfeldJLSchoenREPinskyPF. Flexible sigmoidoscopy in the PLCO cancer screening trial: results from the baseline screening examination of a randomized trial. J Natl Cancer Inst2005;97:989997.

    • Search Google Scholar
    • Export Citation
  • 44.

    WeissfeldJLSchoenREPinskyPF. Flexible sigmoidoscopy in the randomized prostate, lung, colorectal, and ovarian (PLCO) cancer screening trial: added yield from a second screening examination. J Natl Cancer Inst2012;104:280289.

    • Search Google Scholar
    • Export Citation
  • 45.

    ElmunzerBJHaywardRASchoenfeldPS. Effect of flexible sigmoidoscopy-based screening on incidence and mortality of colorectal cancer: a systematic review and meta-analysis of randomized controlled trials. PLoS Med2012;9:e1001352.

    • Search Google Scholar
    • Export Citation
  • 46.

    WangYRCangemiJRLoftusEVJrPiccoMF. Risk of colorectal cancer after colonoscopy compared with flexible sigmoidoscopy or no lower endoscopy among older patients in the United States, 1998-2005. Mayo Clin Proc2013;88:464470.

    • Search Google Scholar
    • Export Citation
  • 47.

    DoubeniCAWeinmannSAdamsK. Screening colonoscopy and risk for incident late-stage colorectal cancer diagnosis in average-risk adults: a nested case-control study. Ann Intern Med2013;158:312320.

    • Search Google Scholar
    • Export Citation
  • 48.

    SchoenREPinskyPFWeissfeldJL. Colorectal cancers not detected by screening flexible sigmoidoscopy in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Gastrointest Endosc2012;75:612620.

    • Search Google Scholar
    • Export Citation
  • 49.

    KimDHPickhardtPJTaylorAJMeniasCO. Imaging evaluation of complications at optical colonoscopy. Curr Probl Diagn Radiol2008;37:165177.

    • Search Google Scholar
    • Export Citation
  • 50.

    WhitlockEPLinJSLilesE. Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force. Ann Intern Med2008;149:638658.

    • Search Google Scholar
    • Export Citation
  • 51.

    JohnsonCDChenMHToledanoAY. Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med2008;359:12071217.

  • 52.

    JohnsonCDToledanoAYHermanBA. Computerized tomographic colonography: performance evaluation in a retrospective multicenter setting. Gastroenterology2003;125:688695.

    • Search Google Scholar
    • Export Citation
  • 53.

    RockeyDCPaulsonENiedzwieckiD. Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet2005;365:305311.

    • Search Google Scholar
    • Export Citation
  • 54.

    PickhardtPJChoiJRHwangI. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med2003;349:21912200.

    • Search Google Scholar
    • Export Citation
  • 55.

    KimDHPickhardtPJTaylorAJ. CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med2007;357:14031412.

    • Search Google Scholar
    • Export Citation
  • 56.

    HalliganSAltmanDGTaylorSA. CT colonography in the detection of colorectal polyps and cancer: systematic review, meta-analysis, and proposed minimum data set for study level reporting. Radiology2005;237:893904.

    • Search Google Scholar
    • Export Citation
  • 57.

    MulhallBPVeerappanGRJacksonJL. Meta-analysis: computed tomographic colonography. Ann Intern Med2005;142:635650.

  • 58.

    PickhardtPJHassanCHalliganSMarmoR. Colorectal cancer: CT colonography and colonoscopy for detection—systematic review and meta-analysis. Radiology2011;259:393405.

    • Search Google Scholar
    • Export Citation
  • 59.

    de HaanMCvan GelderREGraserA. Diagnostic value of CT-colonography as compared to colonoscopy in an asymptomatic screening population: a meta-analysis. Eur Radiol2011;21:17471763.

    • Search Google Scholar
    • Export Citation
  • 60.

    StoopEMde HaanMCde WijkersloothTR. Participation and yield of colonoscopy versus non-cathartic CT colonography in population-based screening for colorectal cancer: a randomised controlled trial. Lancet Oncol2012;13:5564.

    • Search Google Scholar
    • Export Citation
  • 61.

    ZalisMEBlakeMACaiW. Diagnostic accuracy of laxative-free computed tomographic colonography for detection of adenomatous polyps in asymptomatic adults: a prospective evaluation. Ann Intern Med2012;156:692702.

    • Search Google Scholar
    • Export Citation
  • 62.

    FletcherJGChenMHHermanBA. Can radiologist training and testing ensure high performance in CT colonography? Lessons from the National CT Colonography Trial. AJR Am J Roentgenol2010;195:117125.

    • Search Google Scholar
    • Export Citation
  • 63.

    LinOS. Computed tomographic colonography: hope or hype?World J Gastroenterol2010;16:915920.

  • 64.

    Berrington de GonzalezAKimKPYeeJ. CT colonography: perforation rates and potential radiation risks. Gastrointest Endosc Clin N Am2010;20:279291.

    • Search Google Scholar
    • Export Citation
  • 65.

    ACR Practice Guideline for the Performance of Coputed Tomography (CT) Colonography in Adults. 2009. Available at: http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/CT_Colonography.pdf. Accessed June 1 2011.

    • Search Google Scholar
    • Export Citation
  • 66.

    SoxHC. Office-based testing for fecal occult blood: do only in case of emergency. Ann Intern Med2005;142:146148.

  • 67.

    CollinsJFLiebermanDADurbinTEWeissDG. Accuracy of screening for fecal occult blood on a single stool sample obtained by digital rectal examination: a comparison with recommended sampling practice. Ann Intern Med2005;142:8185.

    • Search Google Scholar
    • Export Citation
  • 68.

    NadelMRBerkowitzZKlabundeCN. Fecal occult blood testing beliefs and practices of U.S. primary care physicians: serious deviations from evidence-based recommendations. J Gen Intern Med2010;25:833839.

    • Search Google Scholar
    • Export Citation
  • 69.

    HardcastleJDChamberlainJORobinsonMH. Randomised controlled trial of faecal-occult-blood screening for colorectal cancer. Lancet1996;348:14721477.

    • Search Google Scholar
    • Export Citation
  • 70.

    KronborgOFengerCOlsenJ. Randomised study of screening for colorectal cancer with faecal-occult-blood test. Lancet1996;348:14671471.

  • 71.

    MandelJSBondJHChurchTR. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med1993;328:13651371.

    • Search Google Scholar
    • Export Citation
  • 72.

    ScholefieldJHMossSMManghamCM. Nottingham trial of faecal occult blood testing for colorectal cancer: a 20-year follow-up. Gut2012;61:10361040.

    • Search Google Scholar
    • Export Citation
  • 73.

    HewitsonPGlasziouPWatsonE. Cochrane systematic review of colorectal cancer screening using the fecal occult blood test (hemoccult): an update. Am J Gastroenterol2008;103:15411549.

    • Search Google Scholar
    • Export Citation
  • 74.

    AllisonJETekawaISRansomLJAdrainAL. A comparison of fecal occult-blood tests for colorectal-cancer screening. N Engl J Med1996;334:155159.

    • Search Google Scholar
    • Export Citation
  • 75.

    LeeTJCliffordGMRajasekharP. High yield of colorectal neoplasia detected by colonoscopy following a positive faecal occult blood test in the NHS Bowel Cancer Screening Programme. J Med Screen2011;18:8286.

    • Search Google Scholar
    • Export Citation
  • 76.

    HundtSHaugUBrennerH. Comparative evaluation of immunochemical fecal occult blood tests for colorectal adenoma detection. Ann Intern Med2009;150:162169.

    • Search Google Scholar
    • Export Citation
  • 77.

    AllisonJESakodaLCLevinTR. Screening for colorectal neoplasms with new fecal occult blood tests: update on performance characteristics. J Natl Cancer Inst2007;99:14621470.

    • Search Google Scholar
    • Export Citation
  • 78.

    HolLVan LeerdamMEVan BallegooijenM. Screening for colorectal cancer: randomised trial comparing guaiac-based and immunochemical faecal occult blood testing and flexible sigmoidoscopy. Gut2010;59:6268.

    • Search Google Scholar
    • Export Citation
  • 79.

    ImperialeTF. Noninvasive screening tests for colorectal cancer. Dig Dis2012;30(Suppl 2):1626.

  • 80.

    ParkDIRyuSKimYH. Comparison of guaiac-based and quantitative immunochemical fecal occult blood testing in a population at average risk undergoing colorectal cancer screening. Am J Gastroenterol2010;105:20172025.

    • Search Google Scholar
    • Export Citation
  • 81.

    Parra-BlancoAGimeno-GarciaAZQuinteroE. Diagnostic accuracy of immunochemical versus guaiac faecal occult blood tests for colorectal cancer screening. J Gastroenterol2010;45:703712.

    • Search Google Scholar
    • Export Citation
  • 82.

    RabeneckLRumbleRBThompsonF. Fecal immunochemical tests compared with guaiac fecal occult blood tests for population-based colorectal cancer screening. Can J Gastroenterol2012;26:131147.

    • Search Google Scholar
    • Export Citation
  • 83.

    OsbornNKAhlquistDA. Stool screening for colorectal cancer: molecular approaches. Gastroenterology2005;128:192206.

  • 84.

    ImperialeTFRansohoffDFItzkowitzSH. Fecal DNA versus fecal occult blood for colorectal-cancer screening in an average-risk population. N Engl J Med2004;351:27042714.

    • Search Google Scholar
    • Export Citation
  • 85.

    AhlquistDASargentDJLoprinziCL. Stool DNA and occult blood testing for screen detection of colorectal neoplasia. Ann Intern Med2008;149:441450W481.

    • Search Google Scholar
    • Export Citation
  • 86.

    AhlquistDAZouHDomanicoM. Next-generation stool DNA test accurately detects colorectal cancer and large adenomas. Gastroenterology2012;142:248256; quiz e225-246.

    • Search Google Scholar
    • Export Citation
  • 87.

    NedRMMelilloSMarroneM. Fecal DNA testing for colorectal cancer screening: the ColoSure test. PLoS Curr2011;3:RRN1220.

  • 88.

    FriedensonB. BRCA1 and BRCA2 pathways and the risk of cancers other than breast or ovarian. MedGenMed2005;7:60.

  • 89.

    KadouriLHubertARotenbergY. Cancer risks in carriers of the BRCA1/2 Ashkenazi founder mutations. J Med Genet2007;44:467471.

  • 90.

    LuoWCaoYLiaoCGaoF. Diabetes mellitus and the incidence and mortality of colorectal cancer: a meta-analysis of 24 cohort studies. Colorectal Dis2012;14:13011312.

    • Search Google Scholar
    • Export Citation
  • 91.

    TheuerCPWagnerJLTaylorTH. Racial and ethnic colorectal cancer patterns affect the cost-effectiveness of colorectal cancer screening in the United States. Gastroenterology2001;120:848856.

    • Search Google Scholar
    • Export Citation
  • 92.

    AgrawalSBhupinderjitABhutaniMS. Colorectal cancer in African Americans. Am J Gastroenterol2005;100:515523; discussion 514.

  • 93.

    SiegelRNaishadhamDJemalA. Cancer statistics, 2012. CA Cancer J Clin2012;62:1029.

  • 94.

    KnudsenABHurCGazelleGS. Rescreening of persons with a negative colonoscopy result: results from a microsimulation model. Ann Intern Med2012;157:611620.

    • Search Google Scholar
    • Export Citation
  • 95.

    HeresbachDBarriozTLapalusMG. Miss rate for colorectal neoplastic polyps: a prospective multicenter study of back-to-back video colonoscopies. Endoscopy2008;40:284290.

    • Search Google Scholar
    • Export Citation
  • 96.

    AlvarezCAndreuMCastellsA. Relationship of colonoscopy-detected serrated polyps with synchronous advanced neoplasia in average-risk individuals. Gastrointest Endosc2013;78:333341.

    • Search Google Scholar
    • Export Citation
  • 97.

    RexDKAhnenDJBaronJA. Serrated lesions of the colorectum: review and recommendations from an expert panel. Am J Gastroenterol2012;107:13151329; quiz 1314 1330.

    • Search Google Scholar
    • Export Citation
  • 98.

    SalariaSNStreppelMMLeeLA. Sessile serrated adenomas: high-risk lesions?Hum Pathol2012;43:18081814.

  • 99.

    ChowELiptonLLynchE. Hyperplastic polyposis syndrome: phenotypic presentations and the role of MBD4 and MYH. Gastroenterology2006;131:3039.

    • Search Google Scholar
    • Export Citation
  • 100.

    RubioCAStemmeSJaramilloELindblomA. Hyperplastic polyposis coli syndrome and colorectal carcinoma. Endoscopy2006;38:266270.

  • 101.

    YeomanAYoungJArnoldJ. Hyperplastic polyposis in the New Zealand population: a condition associated with increased colorectal cancer risk and European ancestry. N Z Med J2007;120:U2827.

    • Search Google Scholar
    • Export Citation
  • 102.

    FerrandezASamowitzWDiSarioJABurtRW. Phenotypic characteristics and risk of cancer development in hyperplastic polyposis: case series and literature review. Am J Gastroenterol2004;99:20122018.

    • Search Google Scholar
    • Export Citation
  • 103.

    LeggettBADevereauxBBidenK. Hyperplastic polyposis: association with colorectal cancer. Am J Surg Pathol2001;25:177184.

  • 104.

    WinawerSJZauberAGFletcherRH. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. CA Cancer J Clin2006;56:143159; quiz 184-145.

    • Search Google Scholar
    • Export Citation
  • 105.

    LiebermanDARexDKWinawerSJ. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology2012;143:844857.

    • Search Google Scholar
    • Export Citation
  • 106.

    RobertsonDJBurkeCAWelchHG. Using the results of a baseline and a surveillance colonoscopy to predict recurrent adenomas with high-risk characteristics. Ann Intern Med2009;151:103109.

    • Search Google Scholar
    • Export Citation
  • 107.

    O’BrienMJWinawerSJZauberAG. The National Polyp Study. Patient and polyp characteristics associated with high-grade dysplasia in colorectal adenomas. Gastroenterology1990;98:371379.

    • Search Google Scholar
    • Export Citation
  • 108.

    GolembeskiCMcKennaBAppelmanHD. Advanced adenomas: pathologists don’t agree [abstract]. Modern Pathology2007;20:Abstract 115A.

  • 109.

    BrennerHChang-ClaudeJRickertA. Risk of colorectal cancer after detection and removal of adenomas at colonoscopy: population-based case-control study. J Clin Oncol2012;30:29692976.

    • Search Google Scholar
    • Export Citation
  • 110.

    WalshRMAckroydFWShellitoPC. Endoscopic resection of large sessile colorectal polyps. Gastrointest Endosc1992;38:303309.

  • 111.

    RexDKKahiCJLevinB. Guidelines for colonoscopy surveillance after cancer resection: a consensus update by the American Cancer Society and US Multi-Society Task Force on Colorectal Cancer. CA Cancer J Clin2006;56:160167; quiz 185-166.

    • Search Google Scholar
    • Export Citation
  • 112.

    Rodriguez-MorantaFSaloJArcusaA. Postoperative surveillance in patients with colorectal cancer who have undergone curative resection: a prospective, multicenter, randomized, controlled trial. J Clin Oncol2006;24:386393.

    • Search Google Scholar
    • Export Citation
  • 113.

    SargentDJWieandHSHallerDG. Disease-free survival versus overall survival as a primary end point for adjuvant colon cancer studies: individual patient data from 20,898 patients on 18 randomized trials. J Clin Oncol2005;23:86648670.

    • Search Google Scholar
    • Export Citation
  • 114.

    ShureiqiICooksleyCDMorrisJ. Effect of age on risk of second primary colorectal cancer. J Natl Cancer Inst2001;93:12641266.

  • 115.

    HoffmanJPRileyLCarpNZLitwinS. Isolated locally recurrent rectal cancer: a review of incidence, presentation, and management. Semin Oncol1993;20:506519.

    • Search Google Scholar
    • Export Citation
  • 116.

    LowyAMRichTASkibberJM. Preoperative infusional chemoradiation, selective intraoperative radiation, and resection for locally advanced pelvic recurrence of colorectal adenocarcinoma. Ann Surg1996;223:177185.

    • Search Google Scholar
    • Export Citation
  • 117.

    YuTKBhosalePRCraneCH. Patterns of locoregional recurrence after surgery and radiotherapy or chemoradiation for rectal cancer. Int J Radiat Oncol Biol Phys2008;71:11751180.

    • Search Google Scholar
    • Export Citation
  • 118.

    GreenRJMetlayJPPropertK. Surveillance for second primary colorectal cancer after adjuvant chemotherapy: an analysis of Intergroup 0089. Ann Intern Med2002;136:261269.

    • Search Google Scholar
    • Export Citation
  • 119.

    PietraNSarliLCostiR. Role of follow-up in management of local recurrences of colorectal cancer: a prospective, randomized study. Dis Colon Rectum1998;41:11271133.

    • Search Google Scholar
    • Export Citation
  • 120.

    SeccoGBFardelliRGianquintoD. Efficacy and cost of risk-adapted follow-up in patients after colorectal cancer surgery: a prospective, randomized and controlled trial. Eur J Surg Oncol2002;28:418423.

    • Search Google Scholar
    • Export Citation
  • 121.

    DeschCEBensonABSomerfieldMR. Colorectal cancer surveillance: 2005 update of an American Society of Clinical Oncology practice guideline. J Clin Oncol2005;23:85128519.

    • Search Google Scholar
    • Export Citation
  • 122.

    JefferyMHickeyBEHiderPN. Follow-up strategies for patients treated for non-metastatic colorectal cancer. Cochrane Database Syst Rev2007:CD002200.

    • Search Google Scholar
    • Export Citation
  • 123.

    RenehanAGEggerMSaundersMPO’DwyerST. Impact on survival of intensive follow up after curative resection for colorectal cancer: systematic review and meta-analysis of randomised trials. BMJ2002;324:813813.

    • Search Google Scholar
    • Export Citation
  • 124.

    TepperJEO’ConnellMNiedzwieckiD. Adjuvant therapy in rectal cancer: analysis of stage, sex, and local control—final report of intergroup 0114. J Clin Oncol2002;20:17441750.

    • Search Google Scholar
    • Export Citation
  • 125.

    GuyotFFaivreJManfrediS. Time trends in the treatment and survival of recurrences from colorectal cancer. Ann Oncol2005;16:756761.

  • 126.

    Li DestriGDi CataldoAPuleoS. Colorectal cancer follow-up: useful or useless?Surg Oncol2006;15:112.

  • 127.

    PfisterDGBensonAB3rdSomerfieldMR. Clinical practice. Surveillance strategies after curative treatment of colorectal cancer. N Engl J Med2004;350:23752382.

    • Search Google Scholar
    • Export Citation
  • 128.

    BeaugerieLSvrcekMSeksikP. Risk of colorectal high-grade dysplasia and cancer in a prospective observational cohort of patients with inflammatory bowel disease. Gastroenterology2013;145:166175.

    • Search Google Scholar
    • Export Citation
  • 129.

    LutgensMWvan OijenMGvan der HeijdenGJ. Declining risk of colorectal cancer in inflammatory bowel disease: an updated meta-analysis of population-based cohort studies. Inflamm Bowel Dis2013;19:789799.

    • Search Google Scholar
    • Export Citation
  • 130.

    EadenJAAbramsKRMayberryJF. The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut2001;48:526535.

  • 131.

    FarrayeFAOdzeRDEadenJ. AGA medical position statement on the diagnosis and management of colorectal neoplasia in inflammatory bowel disease. Gastroenterology2010;138:738745.

    • Search Google Scholar
    • Export Citation
  • 132.

    KornbluthASacharDB. Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol2010;105:501523; quiz 524.

    • Search Google Scholar
    • Export Citation
  • 133.

    NeumannHViethMLangnerC. Cancer risk in IBD: how to diagnose and how to manage DALM and ALM. World J Gastroenterol2011;17:31843191.

  • 134.

    UmarABolandCRTerdimanJP. Revised Bethesda Guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability. J Natl Cancer Inst2004;96:261268.

    • Search Google Scholar
    • Export Citation
  • 135.

    TaylorDPBurtRWWilliamsMS. Population-based family history-specific risks for colorectal cancer: a constellation approach. Gastroenterology2010;138:877885.

    • Search Google Scholar
    • Export Citation
  • 136.

    ImperialeTFRansohoffDF. Risk for colorectal cancer in persons with a family history of adenomatous polyps: a systematic review. Ann Intern Med2012;156:703709.

    • Search Google Scholar
    • Export Citation
  • 137.

    AaltonenLASalovaaraRKristoP. Incidence of hereditary nonpolyposis colorectal cancer and the feasibility of molecular screening for the disease. N Engl J Med1998;338:14811487.

    • Search Google Scholar
    • Export Citation
  • 138.

    HampelHFrankelWLMartinE. Screening for the Lynch syndrome (hereditary nonpolyposis colorectal cancer). N Engl J Med2005;352:18511860.

    • Search Google Scholar
    • Export Citation
  • 139.

    HampelHFrankelWLMartinE. Feasibility of screening for Lynch syndrome among patients with colorectal cancer. J Clin Oncol2008;26:57835788.

    • Search Google Scholar
    • Export Citation
  • 140.

    LynchHTde la ChapelleA. Hereditary colorectal cancer. N Engl J Med2003;348:919932.

  • 141.

    BolandCRGoelA. Microsatellite instability in colorectal cancer. Gastroenterology2010;138:20732087e2073.

  • 142.

    KempersMJKuiperRPOckeloenCW. Risk of colorectal and endometrial cancers in EPCAM deletion-positive Lynch syndrome: a cohort study. Lancet Oncol2011;12:4955.

    • Search Google Scholar
    • Export Citation
  • 143.

    RumillaKSchowalterKVLindorNM. Frequency of deletions of EPCAM (TACSTD1) in MSH2-associated Lynch syndrome cases. J Mol Diagn2011;13:9399.

    • Search Google Scholar
    • Export Citation
  • 144.

    VasenHFWijnenJTMenkoFH. Cancer risk in families with hereditary nonpolyposis colorectal cancer diagnosed by mutation analysis. Gastroenterology1996;110:10201027.

    • Search Google Scholar
    • Export Citation
  • 145.

    AaltonenLAPeltomakiPMecklinJP. Replication errors in benign and malignant tumors from hereditary nonpolyposis colorectal cancer patients. Cancer Res1994;54:16451648.

    • Search Google Scholar
    • Export Citation
  • 146.

    MosleinGTesterDJLindorNM. Microsatellite instability and mutation analysis of hMSH2 and hMLH1 in patients with sporadic, familial and hereditary colorectal cancer. Hum Mol Genet1996;5:12451252.

    • Search Google Scholar
    • Export Citation
  • 147.

    JarvinenHJMecklinJPSistonenP. Screening reduces colorectal cancer rate in families with hereditary nonpolyposis colorectal cancer. Gastroenterology1995;108:14051411.

    • Search Google Scholar
    • Export Citation
  • 148.

    LindorNMPetersenGMHadleyDW. Recommendations for the care of individuals with an inherited predisposition to Lynch syndrome: a systematic review. JAMA2006;296:15071517.

    • Search Google Scholar
    • Export Citation
  • 149.

    VasenHFWatsonPMecklinJPLynchHT. New clinical criteria for hereditary nonpolyposis colorectal cancer (HNPCC, Lynch syndrome) proposed by the International Collaborative group on HNPCC. Gastroenterology1999;116:14531456.

    • Search Google Scholar
    • Export Citation
  • 150.

    VasenHF. Clinical diagnosis and management of hereditary colorectal cancer syndromes. J Clin Oncol2000;18(21 Suppl):81S92S.

  • 151.

    BarnetsonRATenesaAFarringtonSM. Identification and survival of carriers of mutations in DNA mismatch-repair genes in colon cancer. N Engl J Med2006;354:27512763.

    • Search Google Scholar
    • Export Citation
  • 152.

    Rodriguez-BigasMABolandCRHamiltonSR. A National Cancer Institute workshop on hereditary nonpolyposis colorectal cancer syndrome: meeting highlights and Bethesda guidelines. J Natl Cancer Inst1997;89:17581762.

    • Search Google Scholar
    • Export Citation
  • 153.

    RaedleJTrojanJBriegerA. Bethesda guidelines: relation to microsatellite instability and MLH1 promoter methylation in patients with colorectal cancer. Ann Intern Med2001;135:566576.

    • Search Google Scholar
    • Export Citation
  • 154.

    PinolVCastellsAAndreuM. Accuracy of revised Bethesda guidelines, microsatellite instability, and immunohistochemistry for the identification of patients with hereditary nonpolyposis colorectal cancer. JAMA2005;293:19861994.

    • Search Google Scholar
    • Export Citation
  • 155.

    RamseySDClarkeLEtzioniR. Cost-effectiveness of microsatellite instability screening as a method for detecting hereditary nonpolyposis colorectal cancer. Ann Intern Med2001;135:577588.

    • Search Google Scholar
    • Export Citation
  • 156.

    BalmanaJStockwellDHSteyerbergEW. Prediction of MLH1 and MSH2 mutations in Lynch syndrome. JAMA2006;296:14691478.

  • 157.

    ChenSWangWLeeS. Prediction of germline mutations and cancer risk in the Lynch syndrome. JAMA2006;296:14791487.

  • 158.

    KastrinosFSteyerbergEWMercadoR. The PREMM(1,2,6) model predicts risk of MLH1, MSH2, and MSH6 germline mutations based on cancer history. Gastroenterology2011;140:7381.

    • Search Google Scholar
    • Export Citation
  • 159.

    BeamerLCGrantMLEspenschiedCR. Reflex immunohistochemistry and microsatellite instability testing of colorectal tumors for lynch syndrome among US cancer programs and follow-up of abnormal results. J Clin Oncol2012;30:10581063.

    • Search Google Scholar
    • Export Citation
  • 160.

    BurtRW. Who should have genetic testing for the lynch syndrome?Ann Intern Med2011;155:127128.

  • 161.

    Recommendations from the EGAPP Working Group: genetic testing strategies in newly diagnosed individuals with colorectal cancer aimed at reducing morbidity and mortality from Lynch syndrome in relatives. Genet Med2009;11:3541.

    • Search Google Scholar
    • Export Citation
  • 162.

    LadabaumUWangGTerdimanJ. Strategies to identify the Lynch syndrome among patients with colorectal cancer: a cost-effectiveness analysis. Ann Intern Med2011;155:6979.

    • Search Google Scholar
    • Export Citation
  • 163.

    PalomakiGEMcClainMRMelilloS. EGAPP supplementary evidence review: DNA testing strategies aimed at reducing morbidity and mortality from Lynch syndrome. Genet Med2009;11:4265.

    • Search Google Scholar
    • Export Citation
  • 164.

    HealdBPlesecTLiuX. Implementation of universal microsatellite instability and immunohistochemistry screening for diagnosing lynch syndrome in a large academic medical center. J Clin Oncol2013;31:13361340.

    • Search Google Scholar
    • Export Citation
  • 165.

    MoreiraLBalaguerFLindorN. Identification of Lynch syndrome among patients with colorectal cancer. JAMA2012;308:15551565.

  • 166.

    BolandCRShikeM. Report from the Jerusalem workshop on Lynch syndrome-hereditary nonpolyposis colorectal cancer. Gastroenterology2010;138:2197e2191-2197.

    • Search Google Scholar
    • Export Citation
  • 167.

    HendriksYMde JongAEMorreauH. Diagnostic approach and management of Lynch syndrome (hereditary nonpolyposis colorectal carcinoma): a guide for clinicians. CA Cancer J Clin2006;56:213225.

    • Search Google Scholar
    • Export Citation
  • 168.

    CaldesTGodinoJSanchezA. Immunohistochemistry and microsatellite instability testing for selecting MLH1, MSH2 and MSH6 mutation carriers in hereditary non-polyposis colorectal cancer. Oncol Rep2004;12:621629.

    • Search Google Scholar
    • Export Citation
  • 169.

    VasenHFHendriksYde JongAE. Identification of HNPCC by molecular analysis of colorectal and endometrial tumors. Dis Markers2004;20:207213.

    • Search Google Scholar
    • Export Citation
  • 170.

    HampelHFrankelWPanescuJ. Screening for Lynch syndrome (hereditary nonpolyposis colorectal cancer) among endometrial cancer patients. Cancer Res2006;66:78107817.

    • Search Google Scholar
    • Export Citation
  • 171.

    LindorNMBurgartLJLeontovichO. Immunohistochemistry versus microsatellite instability testing in phenotyping colorectal tumors. J Clin Oncol2002;20:10431048.

    • Search Google Scholar
    • Export Citation
  • 172.

    ReyesCMAllenBATerdimanJPWilsonLS. Comparison of selection strategies for genetic testing of patients with hereditary nonpolyposis colorectal carcinoma: effectiveness and cost-effectiveness. Cancer2002;95:18481856.

    • Search Google Scholar
    • Export Citation
  • 173.

    ShiaJKlimstraDSNafaK. Value of immunohistochemical detection of DNA mismatch repair proteins in predicting germline mutation in hereditary colorectal neoplasms. Am J Surg Pathol2005;29:96104.

    • Search Google Scholar
    • Export Citation
  • 174.

    PinoMSChungDC. Application of molecular diagnostics for the detection of Lynch syndrome. Expert Rev Mol Diagn2010;10:651665.

  • 175.

    Lagerstedt RobinsonKLiuTVandrovcovaJ. Lynch syndrome (hereditary nonpolyposis colorectal cancer) diagnostics. J Natl Cancer Inst2007;99:291299.

    • Search Google Scholar
    • Export Citation
  • 176.

    YurgelunMBGoelAHornickJL. Microsatellite instability and DNA mismatch repair protein deficiency in lynch syndrome colorectal polyps. Cancer Prev Res (Phila)2012;5:574582.

    • Search Google Scholar
    • Export Citation
  • 177.

    BurtRW. Diagnosing lynch syndrome: more light at the end of the tunnel. Cancer Prev Res (Phila)2012;5:507510.

  • 178.

    DinhTARosnerBIAtwoodJC. Health benefits and cost-effectiveness of primary genetic screening for Lynch syndrome in the general population. Cancer Prev Res (Phila)2011;4:922.

    • Search Google Scholar
    • Export Citation
  • 179.

    WardRLHicksSHawkinsNJ. Population-based molecular screening for Lynch syndrome: implications for personalized medicine. J Clin Oncol2013;31:25542562.

    • Search Google Scholar
    • Export Citation
  • 180.

    BonadonaVBonaitiBOlschwangS. Cancer risks associated with germline mutations in MLH1, MSH2, and MSH6 genes in Lynch syndrome. JAMA2011;305:23042310.

    • Search Google Scholar
    • Export Citation
  • 181.

    EngelCLoefflerMSteinkeV. Risks of less common cancers in proven mutation carriers with lynch syndrome. J Clin Oncol2012;30:44094415.

    • Search Google Scholar
    • Export Citation
  • 182.

    KohlmannWGruberS. Lynch syndrome. In: PagonRAAdamMPBirdTD eds. GeneReviews [Internet]. Seattle, WA: University of Washington, Seattle; 19932013.

    • Search Google Scholar
    • Export Citation
  • 183.

    KastrinosFMukherjeeBTayobN. Risk of pancreatic cancer in families with Lynch syndrome. JAMA2009;302:17901795.

  • 184.

    WatsonPVasenHFMecklinJP. The risk of extra-colonic, extra-endometrial cancer in the Lynch syndrome. Int J Cancer2008;123:444449.

  • 185.

    WinAKYoungJPLindorNM. Colorectal and other cancer risks for carriers and noncarriers from families with a DNA mismatch repair gene mutation: a prospective cohort study. J Clin Oncol2012;30:958964.

    • Search Google Scholar
    • Export Citation
  • 186.

    SenterLClendenningMSotamaaK. The clinical phenotype of Lynch syndrome due to germline PMS2 mutations. Gastroenterology2008;135:419428.

    • Search Google Scholar
    • Export Citation
  • 187.

    ChenLMYangKYLittleSE. Gynecologic cancer prevention in Lynch syndrome/hereditary nonpolyposis colorectal cancer families. Obstet Gynecol2007;110:1825.

    • Search Google Scholar
    • Export Citation
  • 188.

    SchmelerKMLynchHTChenLM. Prophylactic surgery to reduce the risk of gynecologic cancers in the Lynch syndrome. N Engl J Med2006;354:261269.

    • Search Google Scholar
    • Export Citation
  • 189.

    AuranenAJoutsiniemiT. A systematic review of gynecological cancer surveillance in women belonging to hereditary nonpolyposis colorectal cancer (Lynch syndrome) families. Acta Obstet Gynecol Scand2011;90:437444.

    • Search Google Scholar
    • Export Citation
  • 190.

    JarvinenHJRenkonen-SinisaloLAktan-CollanK. Ten years after mutation testing for Lynch syndrome: cancer incidence and outcome in mutation-positive and mutation-negative family members. J Clin Oncol2009;27:47934797.

    • Search Google Scholar
    • Export Citation
  • 191.

    Renkonen-SinisaloLButzowRLeminenA. Surveillance for endometrial cancer in hereditary nonpolyposis colorectal cancer syndrome. Int J Cancer2007;120:821824.

    • Search Google Scholar
    • Export Citation
  • 192.

    RijckenFEMouritsMJKleibeukerJH. Gynecologic screening in hereditary nonpolyposis colorectal cancer. Gynecol Oncol2003;91:7480.

  • 193.

    Dove-EdwinIBoksDGoffS. The outcome of endometrial carcinoma surveillance by ultrasound scan in women at risk of hereditary nonpolyposis colorectal carcinoma and familial colorectal carcinoma. Cancer2002;94:17081712.

    • Search Google Scholar
    • Export Citation
  • 194.

    CapelleLGVan GriekenNCLingsmaHF. Risk and epidemiological time trends of gastric cancer in Lynch syndrome carriers in the Netherlands. Gastroenterology2010;138:487492.

    • Search Google Scholar
    • Export Citation
  • 195.

    SchulmannKEngelCProppingPSchmiegelW. Small bowel cancer risk in Lynch syndrome. Gut2008;57:16291630.

  • 196.

    ten KateGLKleibeukerJHNagengastFM. Is surveillance of the small bowel indicated for Lynch syndrome families?Gut2007;56:11981201.

  • 197.

    KoornstraJJKleibeukerJHVasenHF. Small-bowel cancer in Lynch syndrome: is it time for surveillance?Lancet Oncol2008;9:901905.

  • 198.

    Renkonen-SinisaloLSipponenPAarnioM. No support for endoscopic surveillance for gastric cancer in hereditary non-polyposis colorectal cancer. Scand J Gastroenterol2002;37:574577.

    • Search Google Scholar
    • Export Citation
  • 199.

    VasenHFBlancoIAktan-CollanK. Revised guidelines for the clinical management of Lynch syndrome (HNPCC): recommendations by a group of European experts. Gut2013;62:812823.

    • Search Google Scholar
    • Export Citation
  • 200.

    SkeldonSCSemotiukKAronsonM. Patients with Lynch syndrome mismatch repair gene mutations are at higher risk for not only upper tract urothelial cancer but also bladder cancer. Eur Urol2013;63:379385.

    • Search Google Scholar
    • Export Citation
  • 201.

    WinAKLindorNMJenkinsMA. Risk of breast cancer in Lynch syndrome: a systematic review. Breast Cancer Res2013;15:R27.

  • 202.

    BurnJGerdesAMMacraeF. Long-term effect of aspirin on cancer risk in carriers of hereditary colorectal cancer: an analysis from the CAPP2 randomised controlled trial. Lancet2011;378:20812087.

    • Search Google Scholar
    • Export Citation
  • 203.

    ClelandJG. Does aspirin really reduce the risk of colon cancer?Lancet2012;379:1586; author reply 1587.

  • 204.

    JankowskiJBarrHMoayyediP. Does aspirin really reduce the risk of colon cancer?Lancet2012;379:15861587; author reply 1587.

All Time Past Year Past 30 Days
Abstract Views 1 1 0
Full Text Views 400 400 21
PDF Downloads 51 51 4
EPUB Downloads 0 0 0