Prevention and diagnosis of colorectal cancer [Prävention und Diagnose kolorektaler Karzinome]

Colorectal cancer (CRC) is the second most common cancer in Germany with an incidence of 70,000 individuals each year. In 20-30% of cases a positive familial history is present and in 2-5% there is a hereditary tendency to cancer With the identification of the genetic background associated with hereditary CRC, at-risk persons now have the chance to know their individual risk before malignancies develop. The reliable detection and resection of adenomas plays an important role in CRC screening. The development of high-definition television and magnifying endoscopy has provided a new level of imaging quality for detecting neoplastic lesions. With additional chromoendoscopy and narrow band imaging a certain discrimination between neoplastic and non-neoplastic lesions is possible. Colonoscopy is the gold standard for colorectal cancer screening in Germany. However, due to the invasiveness of the procedure and low attendance rates alternative screening methods are warranted. © 2009 Springer Medizin Verlag.