Writing Samples

Rationale for Screening
Colorectal Cancer (CRC) is a good candidate for systematic screening in the general population. It is the second most prevalent cancer in the United States, with about 150,000 new cases and nearly 50,000 deaths per year,1 and its incidence has been rising, both overall and within specific population groups (e.g. blacks).2 Furthermore, early CRC usually has an indolent course and several screening tests—physical, laboratory, endoscopic, and radiologic—can detect the disease before it becomes incurable. Endoscopic techniques such as polypectomy and mucosectomy can even remove premalignant lesions and early cancers on an outpatient basis, further reducing morbidity and mortality.4 A fundamental aspect of CRC screening is risk stratification. This entails the assessment of each patient’s family history, including the diagnosis of hereditary cancer syndromes that predispose to CRC, such as the polyposis syndromes and hereditary non-polyposis colon cancer (HNPCC). Although rare, these pathologies account for a significant proportion (5-10%)2 of colorectal cancer cases, and their detection affords the possibility of diagnosing several early, potentially curable neoplasms in a single family.

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