A combination of tests can help to identify a patient at high risk for colorectal cancer. Such a patient should have early colonoscopy. The authors are from Kangbuk Samsung Hospital, Sungjyunkwan University and Hanyang University in the Republic of Korea.
Patient selection: adult 40 to 49 years of age
Advanced colorectal neoplasia:
(1) cancer
(2) advanced adenoma (one or more of: diameter >= 10 mm, villous component, high-grade dysplasia)
Parameters:
(1) Asia-Pacific Colorectal screening test (range 0 to 4, with 0 points assigned for age)
(2) fecal immunochemical test (FIT with detection of 20 micrograms of hemoglobin per gram of feces, Eiken Chemical Company, Japan)
Asia-Pacific CST
FIT
Percent with Advanced Colorectal Neoplasia
< 2
negative
1%
>= 2
negative
2.1%
< 2
positive
7.1%
>=2 2
positive
13.4%
Colonoscopy is recommended for high-risk individuals.
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