**Meet the editor**

Dr. Rajunor Ettarh is Professor and Vice-Chair for Education in the Department of Structural and Cellular Biology at Tulane University School of Medicine, where he also serves as Director of the Graduate Program in Anatomy. A Fellow of the Royal Society of Medicine in London, he spent much of his research career in Ireland, where his main interests centered on radiobiology and epithelial cell

biology of the digestive tract, the regulatory mechanisms that mediate uninhibited proliferation in gastrointestinal cancers, and potential therapeutic targets. He has published extensively, has previously edited two books on colorectal cancer, and reviews for a number of cancer journals.

## Contents

#### **Preface XI**


## Preface

Colorectal cancer remains a major health issue for many developed regions around the world. The good news is that early detection has significantly improved overall survival rates and continues to do so. A number of prevention strategies contribute to this positive trend – all of which are presented and discussed in this series of chapters. What are the risks? The risks are not good: a 5% risk of being diagnosed with colorectal cancer in one's lifetime. The odds are however getting better: 5-year survival rates of up to 90% if the dis‐ ease is discovered early. For those with predisposing risk factors such as family history, in‐ flammatory bowel disease or adenomatous polyposis, surveillance is recommended.

Surveillance guidelines outlined by several organizations are presented in detail in this book. Whether the aim is to prevent colorectal cancer or to detect the disease early, the role of fecal occult blood tests as well as inspections of the colon by flexible sigmoidoscopy and colonoscopy have been extensively studied and reported. Modalities include programmatic screening of target populations as well as opportunistic tests of patients. What about out‐ comes? Measured around incidence and mortality, screening remains cost effective, al‐ though its value continues to be debated. The issue of interval colorectal cancer remains a challenge. The role that modalities such as computed tomographic colonoscopy and genetic stool testing play in prevention and detection will only become clearer with more data and evidence. Today, a patient who undergoes a colonoscopy for screening purposes stands a much better chance of being effectively surveyed for prevention of colorectal cancer. Pa‐ tients can rely increasingly on the improved datasets and technical advances that are being made in colonoscopic equipment and skills. The future of surveillance looks increasingly positive as long as progress continues, particularly in the partnership between clinicians and computer scientists, for the development of better tools and methods.

#### **ACKNOWLEDGMENTS**

This book would not have been possible without the support of my family. I am also espe‐ cially indebted to process managers Ivona Lovrić and Iva Lipović whose immense patience, timely reminders, and constant assistance and support made the task of editing this book easier.

> **Dr. Rajunor Ettarh** Tulane University, School of Medicine, New Orleans, LA, USA

**Screening with Colonoscopy**
