European guidelines for quality assurance in colorectal cancer screening and diagnosis

Summary:

Colorectal cancer (CRC) is the most common newly-diagnosed cancer and the second most common cause of cancer deaths in Europe. In the 27 Member States of the European Union, CRC ranks second in incidence and mortality in both sexes, with approximately 330 000 new cases and 149 000 deaths estimated for men and women combined in 2008. Even in those Member States in the lower range of age-standardised rates of CRC, the burden of disease is significant compared to other regions of the world. CRC is therefore an important health problem across the EU.

The aim of screening is to lower the burden of cancer in the population by discovering disease in its early latent stages. This permits more effective treatment than if diagnosed later when symptoms occur. Early treatment of invasive lesions, for example by endoscopic resection of early CRC, can be generally less detrimental for quality of life. The endoscopic removal of pre-malignant lesions also reduces the incidence of CRC by stopping the progression to cancer. Randomised trials in people of average risk invited to attend screening have shown a reduction in CRC mortality and incidence.