Intestinal cancer in spite of screening

Only every second patient with colorectal carcinoma had taken part in an early detection program within the last ten years.

This is the result, at least for a group of 212 colorectal cancer patients whose screening behavior is examined in the current edition of Deutsches Ärzteblatt International ( Dtsch Arztebl Int 2009; 106[12]: 195) by Konrad Schoppmeyer and his colleagues from Leipzig University Hospital.

The authors have performed a retrospective analysis of the data on screening examinations for the ten years before the diagnosis of colorectal cancer.

In 83% of patients, the colorectal carcinoma was discovered after symptoms had developed. In 17% of patients, the diagnosis was made during screening. In the 10 years before the diagnosis, 51% of the colorectal cancer patients had used screening tests for early recognition. The most frequent of these was the test for fecal occult blood—although this was mostly not in accordance with the guidelines. 25 patients had undergone colonoscopy, 20 of these within the five years before diagnosis.

The most frequent reason that screening tests were not used was that patients were unaware of what was available. Schoppmeyer et al. therefore advocate that doctors should provide their patients with more detailed advice. Moreover, procedures should be in accordance with the guidelines.