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A New Generation of Molecular Stool Testing

Tony Mak, MB ChB, MD, FRCS1 and James Hill, MB ChB, FRCS, ChM2

Colorectal cancer (CRC) has the second highest mortality rate of all cancers and is the third most common cancer in the UK, with over 30 000 cases diagnosed in 2008 [1]. The majority of CRCs are diagnosed at a relatively late stage (63% at Dukes C or more advanced), and almost 50% of patients newly diagnosed are expected to die within 5 years. Early stage CRCs (Dukes A) are associated with a significantly more favorable prognosis, with a 5-year survival rate of >85% [2]. The detection and removal of precancerous lesions (i.e. adenomas) has been shown to reduce the incidence of CRCs. Thus, CRC is ideal for a screening program because of its natural history. The most recent US cancer statistics have shown a decrease in CRC incidence in both sexes [3]. This reduction may be due to increasing public awareness of the disease and increasing uptake of screening.

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