New Developments in Screening for Colorectal Cancer: Report on the World Endoscopy Organization Workshop Chicago, May 2011

We can expect to see significant changes in how we screen for colorectal cancer over the next decade. Molecular tests, based on faecal or blood samples, are promising in terms of clinical performance and acceptance. The optimal strategy for offering screening remains to be defined. Offering choice of test need not confuse the invitee, provided that this is structured in a sequential manner. It is difficult to compare results between studies using different FIT (fecal immunochemical tests for haemoglobin) products; introduction of a standard method for reporting faecal hemoglobin concentrations would solve this. A number of trials of screening colonoscopy are now underway. These will provide clear guidance about the acceptance, feasibility and value of this invasive screening tool relative to simpler screening tests. Comparative Effectiveness Research, will enable us to objectively compare two or more interventions in a head-to-head design where a major service program is already implemented.