| [ Summary ] |
The screening of colorectal cancer using fecal occult blood test and sigmoidoscopy can reduce mortality, and this has been confirmed through randomized control trials (RCTs). There is an ongoing RCT using colonoscopy. The age-adjusted colorectal cancer (CRC) mortality has decreased owing to CRC screening in the UK (using fecal occult blood test) and in the US (using colonoscopy). Currently, the CRC mortality rates in these countries are lower than the rates in Japan. In Japan, CRC screening using fecal immunochemical tests has been conducted since 1992. However, the effectiveness of this method has not been satisfactory. This is because the rates of performing screening and detailed examinations were low. Thus, improving the rate of undergoing detailed examinations is the need of the hour. The introduction of endoscopy screening should be discussed in the future. However, to reduce the mortality rate associated with CRC further in Japan, both fecal occult blood screening and colonoscopy should be performed for all people. Similar to the model adopted by countries such as the UK, Japan should introduce organized screening using a registry system, thus ensuring the management of all the relevant people. |