Colorectal cancer: update on recent advances and their impact on screening protocols.

As the third leading cause of cancer cases and deaths in the United States, colorectal cancer has been an area of intense interest. The objectives of this article are, through a review of the literature published between 1995 to 1998, to examine current trends in the epidemiology of colorectal cancer, new information on genetic, dietary, and other risk factors; to evaluate the effectiveness of current screening guidelines for various populations; to review information on chemoprevention; and finally to examine new concepts on the horizon in the area of colorectal cancer research. Much of the recent research in the field has focused on etiology, dietary, and other risk factors. Many genetic factors have been discovered, which serve to elucidate the mechanism of pathogenesis of colorectal cancer as well as offer possible targets for treatment strategies. Dietary and risk factors for colorectal cancer may pave the way for chemoprevention. In light of the most recent information on colorectal cancer, one is able to more accurately assess current screening guidelines for their effectiveness in all populations based on epidemiologic data, as well as evaluate more novel screening strategies for their possible utility in the future. In addition to a review of the most up-to-date literature, the authors also provide their recommendations for screening based on the evidence in which the review of the literature provides. Finally, current and future treatment options are discussed. It is our hope that the physicians will find this review useful in the evaluation and care of patients at risk of developing colorectal cancer.