Technological advances: what hope for colorectal cancer?

Abstract

Introduction: Colorectal cancers rank third in all cancers. Mass screening has proven effectiveness by significantly reducing incidence and mortality. If optical colonoscopy is the reference exam, virtual colonoscopy is an alternative of choice. We evaluate its first-line position in screening, following technological progress. Methods: We used PubMed's electronic search data from 2010. Among the 100 most consulted articles, have been studied those in English-language and which looked at screening in the population at average risk aged between 50 and 75 years , asymptomatic and dealing with optical and virtual colonoscopy. Studies in the symptomatic, high-risk, or very high-risk population or for diagnostic purposes were excluded. Results: in the USA, studies confirm the trend towards a decrease in incidence and mortality by colorectal cancers, shifting from 56.7 per 100,000 and 23.6 deaths respectively in 1992 to 36.5 per 100,000 and 14 deaths in 2015, thanks to the means of screening including the endoscopy. Although optical colonoscopy is the standard exam, virtual colonoscopy, with a specificity of 90% and a sensitivity of 85%, is becoming more and more a first-line means of screening for colorectal cancers. Conclusion: Thus, first-line endoscopic screening has proved its effectiveness in reducing morbidity and mortality by this cancer. However, the virtual endoscopy chosen by the National Comprehensive Cancer Network as a means of screening will undoubtedly constitute a strategy for the future, particularly in developing countries.