Updates in colorectal cancer screening

Recent advances in the field of colorectal cancer screening have led to updated guidelines from several national societies. Although various strategies have been illustrated to reduce mortality from colorectal cancer, screening tests differ in their ability to detect neoplasia. While this is an issue for all lesions, it is a particular problem for non-polypoid or ‘flat’ colonic neoplasia, which has been recognized to be prevalent in Western countries. Guidelines also recommend the age at which screening is initiated and discontinued; however, emerging data suggest these thresholds may lead to missed lesions. Finally, evidence points to disparities in the availability and utilization of colorectal cancer screening tests, which may be successfully addressed through interventions that educate both patients and their providers. The focus of future efforts includes increasing adherence to recommended screening strategies.