Overview

In the United States each year colon cancer is diagnosed in approximately 100,000 people and rectal cancer is diagnosed in another 50,000. Colorectal cancer usually affects older adults, with 90 percent of cases diagnosed in individuals 50 years of age and older. Colorectal cancer is often fatal, with approximately 50,000 deaths attributed to it each year in the United States. As such, it is both the third most common type of cancer and the third most common cause of cancer-related death for both men and women. Health care costs associated with care of these cancers is high, second only to breast cancer. Colorectal cancers may be diagnosed during screening of asymptomatic individuals or after a person has developed symptoms. Colon cancer symptoms include abdominal discomfort, change in bowel habits, anemia, and weight loss. Rectal cancer symptoms include bleeding, diarrhea, and pain. The U.S. Preventive Services Task Force currently recommends screening for colorectal cancer in asymptomatic normal-risk individuals using fecal occult blood testing, sigmoidoscopy, or colonoscopy, beginning at age 50 years and continuing until age 75 years. Diagnosis is usually established through histopathologic examination of tissue samples (most often obtained through biopsies performed during colonoscopy). The primary objective of this review is to synthesize the available information on the comparative accuracy and effectiveness of imaging for staging of colorectal cancer. The availability of this information will assist clinicians in selecting protocols for staging, may reduce variability across treatment centers in staging protocols, and may improve patient outcomes. A secondary objective is to identify gaps in the evidence base to inform future research needs. Key Questions addressed include: What is the comparative effectiveness of imaging techniques for pretreatment cancer staging in patients with primary and recurrent colorectal cancer? What is the comparative effectiveness of imaging techniques for restaging cancer in patients with primary and recurrent colorectal cancer after initial treatment?

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