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A risk-stratified approach to colorectal cancer prevention and diagnosis

Lookup NU author(s): Professor Colin Rees, Professor Linda Sharp, Dr Sara Koo


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© 2020, Springer Nature Limited.Population screening and endoscopic surveillance are used widely to prevent the development of and death from colorectal cancer (CRC). However, CRC remains a major cause of cancer mortality and the increasing burden of endoscopic investigations threatens to overwhelm some health services. This Perspective describes the rationale for and approach to improved risk stratification and decision-making for CRC prevention and diagnosis. Limitations of current approaches will be discussed using the UK as an example of the challenges faced by a particular health-care system, followed by discussion of novel risk biomarker utilization. We explore how risk stratification will be advantageous to current health-care providers and users, enabling more efficient use of limited colonoscopy resources. We discuss risk stratification in the setting of population screening as well as the surveillance of high-risk groups and investigation of symptomatic patients. We also address challenges in the development and validation of risk stratification tools and identify key research priorities.

Publication metadata

Author(s): Hull MA, Rees CJ, Sharp L, Koo S

Publication type: Review

Publication status: Published

Journal: Nature Reviews Gastroenterology and Hepatology

Year: 2020

Volume: 17

Pages: 773-780

Print publication date: 01/12/2020

Online publication date: 16/10/2020

Acceptance date: 08/09/2020

ISSN (print): 1759-5045

ISSN (electronic): 1759-5053

Publisher: Nature Research


DOI: 10.1038/s41575-020-00368-3