Colon polyps and cancer.

A large number of studies published last year in peer-reviewed medical journals help to better define the advantages and limitations of the different options for colorectal cancer screening. Direct colonoscopy screening appears to have the greatest potential to markedly reduce both the incidence and mortality of colorectal cancer, but many obstacles limiting its widespread use in the general at-risk population still exist, and many questions remain incompletely answered. Recent studies stress the fact that finding and resecting advanced adenomatous polyps, and thereby preventing cancer, is becoming a primary objective of screening programs. Several papers also show the potential of emerging new methods of screening for specific markers in stool and for imaging the colon with computed-tomographic colonography (virtual colonoscopy). Other important publications highlighted in this review deal with the diagnosis of colorectal neoplasia, familial colorectal cancer, colorectal polyps and the adenoma-carcinoma sequence, and new and novel methods of improving the efficiency and safety of colonoscopic polypectomy.