Colorectal cancer: From prevention to personalized medicine

Table 2 Main colorectal cancer screening tools

Test	Sensitivity	Specificity	Considerations
Colonoscopy		90%	It requires a bowel cleansing preparation and sedation.
Adenoma ≤ 5 mm	70%-79%		Risk of severe complications.
Adenoma 6-9 mm	80%-92%		Not well accepted by population.
Adenoma ≥ 10 mm	92%-99%
CRC	92%-99%
Sigmoidoscopy1		92%	It requires less preparation.
Adenoma ≤ 5 mm	70%-79%		Sedation it is not necessary.
Adenoma 6-9 mm	80%-92%		Proximal lesions are not detected
Adenoma ≥ 10 mm	92%-99%
CRC	90%-92%
gFOBT standard		95%-99%	Dietary and pharmacological interactions.
Adenoma ≤ 5 mm	1%-5%		3 samples
Adenoma 6-9 mm	5%-13.7%
Adenoma ≥ 10 mm	8.9%-27.5%
CRC	25%-50%
gFOBT sensitive		90%-95%	Dietary and pharmacological interactions.
Adenoma ≤ 5 mm	5%-10%		3 samples
Adenoma 6-9 mm	10%-26.2%
Adenoma ≥ 10 mm	17.7%-49.4%
CRC	50%-87%
FIT		92.5%-98%	The sample needs to be refrigerated.
Adenoma ≤ 5 mm	2%-7.5%
Adenoma 6-9 mm	7.5%-24.0%
Adenoma ≥ 10 mm	16%-48%
CRC	50%-87%

¹Sensitivity and specificity only for distal lesions. Data based on the report “Evaluating test strategies for colorectal cancer screening: a decision analysis for the US Preventive Services Task Force”. Available from: URL: http://www.uspreventiveservicestaskforce.org/uspstf08/colocancer/cartzaubtab2.htm. DCBE: Double-contrast barium enema; gFOBT: Guayac fecal occult blood test; FIT: Immunochemical fecal occult blood test; CRC: Colorectal cancer.