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Professor J.R.T. Monson

21 August 2008

CRC screening improves mortality

Despite the lack of international data demonstrating its benefits, colorectal cancer screening does improve mortality, says Professor J.R.T Monson of the University of Hull, UK.

While colonoscopy is the gold standard for colorectal cancer (CRC) screening due to its high sensitivity (90 percent for large adenomas and 75 percent for small adenomas) and specificity, it has its risks. But on the plus side, colonoscopy can be performed by any healthcare professional “as long as they are properly trained”, said Monson.

The fecal occult blood test (FOBT) is a cheap and effective screening modality that has been adopted by the UK as part of the national colon cancer screening program – the first in the world, said Monson. The program
involves biennial FOBT in people aged 60-69. Those who test positive are sent for a colonoscopy.

Three randomized controlled FOBT trials have shown a 15-21 percent mortality rate reduction over eight to 13 years of screening. The trials also showed that annual FOBT reduces the mortality rate by 33 percent and that its accuracy can be increased by the addition of sigmoidoscopy.


Professor of Surgery and Head of Department University of Hull Academic Surgical Unit Hull, United Kingdom

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