|
Test | Advantages | Limitations |
|
Colonoscopy | (i) Highest performance for CRC detection (ii) Views entire colon (iii) Can take biopsies (iv) Can remove polyps
| (i) May not detect some polyps, cancer, and nonpolypoid lesions (ii) Requires sedation (iii) Requires bowel preparation (iv) May cause tearing or perforation [62] |
|
Flexible sigmoidoscopy | (i) High performance for CRC detection in rectum and lower one-third of the colon (ii) Minimal Bowel preparation (iii) Does not require sedation (iv) Can take biopsies (v) Can remove polyps | (i) Cannot detect abnormalities in the upper part of the colon (ii) Very small risk of tearing or perforation [62] |
|
Double-contrast barium enema | (i) High performance for CRC detection (ii) Views entire colon (iii) Does not require sedation | (i) May not detect small polyps and cancer (ii) Requires bowel preparation (iii) May indicate false-positive results (iv) Colonoscopy is needed to remove polyps or perform a biopsy if abnormalities are found |
|
Computer tomographic colonography | (i) High performance for CRC detection (ii) Views entire colon (iii) Does not require sedation (iv) Noninvasive | (i) May not detect some polyps, cancer, and nonpolypoid lesions [63, 64] (ii) Requires bowel preparation (iii) Colonoscopy is needed to remove polyps or perform a biopsy if abnormalities are found [65] |
|
Fecal blood tests | (i) Intermediate performance for CRC detection (ii) Noninvasive (iii) No bowel preparation (iv) Low cost | (i) Fails to detect most polyps and some cancers [66, 67] (ii) May indicate false-positive results [66, 67] (iii) Dietary restrictions may be needed (iv) Needs a confirmatory colonoscopy for positive results |
|
Stool DNA test | (i) Intermediate performance for CRC detection (ii) Noninvasive (iii) No bowel preparation | (i) Will not detect some polyps and cancers (ii) Costly (iii) Uncertain interval for screening (iv) Needs a confirmatory colonoscopy for positive results |
|