Description: This book offers a thorough review of the various strategies for prevention and screening for colorectal cancer including fecal occult blood testing, barium enema, flexible sigmoidoscopy, and colonoscopy.
Purpose: Colorectal cancer is the third most common malignancy affecting people in westernized societies. While screening strategies are still being developed for more common malignancies such as lung cancer, several forms of colorectal cancer screening strategies have already proven their inability to significantly decrease both mortality and morbidity from this disease. Most countries do not actively promote screening for colorectal cancer, but several recent studies have provided evidence that screening and prevention strategies compare favorably with other preventive medicine interventions.
Audience: Because of its focus on screening and prevention rather than treatment of established disease, this book is more intended for general practitioners and gastroenterologists rather than medical or surgical oncologists. Nonetheless, all physicians who care for patients with colorectal cancer will benefit from this book, which is well written, thorough, and up-to-date.
Features: The book provides a sound rationale for large scale screening of this common disease. The authors, two gastroenterologists, a medical oncologist and a family practitioner, have combined their knowledge and expertise on colorectal cancer to address in depth important topics such as colorectal cancer prevention through diet, management of familial risk for colorectal cancer, management and follow-up of early stage colorectal cancer, as well as recognized and hypothetical risk factors for this disease. The pros and cons of population-based colorectal cancer preventive strategies are honestly discussed.
Assessment: I particularly enjoyed the chapter entitled, "How should we screen for early colorectal neoplasia?" This is an objective discussion of the caveats associated with large scale colorectal cancer screening. Acceptability, cost-effectiveness, and individual choice are thoroughly debated. This chapter should be read by all politicians in charge of national screening programs.