Estratégias de rastreamento no câncer colorretal: análise do impacto do monitoramento

Abstract

Colorectal cancer (CRC) is the second leading cause of cancer-related death worldwide, with most cases developing slowly from pre-cancer lesions. Screening is effective in reducing mortality and treatment costs, but uptake of screening is low in many countries, ranging from 19% to 69%. Although screening can initially increase the incidence detected, it is crucial to detect cancer early and improve treatment success rates. Available tests include stool, blood, and imaging tests. This research aims to evaluate the effectiveness of screening in individuals with a family history of CRC, especially to improve guidelines and reduce mortality in the high-risk population. This is a qualitative literature review conducted in September 2024, using databases such as SciELO, BVS, PubMed, and Google Scholar. The search was performed using the terms "Colorectal Cancer" and "screening", combined with "AND". Relevant articles, reviews and book chapters, without time limitations, and written in English or Portuguese were included. Incomplete, duplicated or irrelevant articles were excluded. The selected studies will be analyzed to enrich the discussions and inferences on the topic. CRC treatment faces challenges in early detection and effective treatment, requiring new molecules for diagnosis and therapies. Non-invasive tests include stool tests (gFOBT, FIT and fecal DNA) and radiological exams (barium enema, capsule endoscopy and CTC). Colonoscopy is the gold standard for screening and treatment, being recommended every 10 years, while stool tests vary in recommendations. The analysis highlights that, despite advances, CRC mortality is significant, with colonoscopy and fecal DNA testing showing potential to reduce mortality. However, adherence to guidelines and the effectiveness of the tests are still areas of debate. The future requires more research and adaptations of the guidelines to optimize CRC screening and clinical management.