Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Current Colorectal Cancer Reports
Published in: Current Colorectal Cancer Reports 5/2016

01-10-2016 | Prevention and Early Detection (R Benamouzig, Section Editor)

Colorectal Cancer Screening: a North American Point of View

Authors: Induruwa N. Pathirana, Dustin M. Albert, Patrick E. Young, Craig M. Womeldorph

Published in: Current Colorectal Cancer Reports | Issue 5/2016

Login to get access

Abstract

Worldwide, colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and second in females, with an estimated 1.4 million cases and 693,900 deaths in 2012. The current screening modalities utilized in the USA are examined in this review, along with current colonoscopy quality indicators. The contribution of CRC screening to the rising cost of health care in the USA has warranted recent public interest and has overall been demonstrated to be cost-effective. In addition, numerous barriers to screening are analyzed along with models for risk stratifying CRC risk at both an individual and population level. Recently, recognized risk stratification models from the Netherlands and Asia are compared with those developed in the USA, and the applicability of each to the US population is evaluated. Ultimately, this review presents the challenges and potential solutions in moving forward in the realm of CRC screening.
Literature
1.
Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide: IARC CancerBase No. 11 [Internet]. Lyon: International Agency for Research on Cancer; 2013. Available from: http://​globocan.​iarc.​fr.
2.
Singh H, Nugent Z, Demers AA, Kliewer EV, Mahmud SM, Bernstein CN. The reduction in colorectal cancer mortality after colonoscopy varies by site of the cancer. Gastroenterology. 2010;139:1128–37.CrossRefPubMed
3.
Atkins WS, Edwards R, Kralj-Hans I, et al. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicenter randomized controlled trial. Lancet. 2010;375(9726):1624–33.CrossRef
4.
Brenner H, Hoffmeister M, Arndt V, Stegmaier C, Altenhofen L, Haug U. Protection form right- and left-sided colorectal neoplasms after colonoscopy: population-based study. J Natl Cancer Inst. 2010;102(2):89–95.CrossRefPubMed
5.
Baxter NN, Goldwasser MA, Paszat LF, Saskin R, Urbach DR, Rabeneck L. Association of colonoscopy and death from colorectal cancer. Ann Intern Med. 2009;150(1):1–8.CrossRefPubMed
6.
Auge JM, Pellise M, Escudero JM, et al. Risk stratification for advanced colorectal neoplasia according to fecal hemoglobin concentration in a colorectal cancer screening program. Gastroenterology. 2014;147:628–36.CrossRefPubMed
7.
Kahi CJ, Imperiale TF, Juliar BE, Rex DK. Effect of screening colonoscopy on colorectal cancer incidence and mortality. Clin Gastroenterol Hepatol. 2009;7(7):770–5.CrossRefPubMed
8.
Lieberman D. Progress and challenges in colorectal cancer screening and surveillance. Gastroenterology. 2010;138(6):2115–26.CrossRefPubMed
9.••
Yang DX, Gross CP, Soulos PR, Yu JB. Estimating the magnitude of colorectal cancers prevented during the era of screening: 1976 to 2009. Cancer. 2014;120(18):2893–901. An evaluation of the true value of colorectal cancer screening.CrossRefPubMed
10.
11.
Sharaf RN, Ladabaum U. Comparative effectiveness and cost-effectiveness of screening colonoscopy vs. sigmoidoscopy and alternative strategies. Am J Gastroenterol. 2013;108:120–32.CrossRefPubMed
12.
13.
Levin B, Lieberman DA, McFarland B, American Cancer Society Colorectal Cancer Advisory Group; US Multi-Society Task Force; American College of Radiology Colon Cancer Committee, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology. 2008;134(5):1570–95.CrossRefPubMed
14.
Winawer SJ, Zauber AG, Nah Ho M, et al. Prevention of colorectal cancer by colonoscopy polypectomy. N Engl J Med. 1993;329(27):1977–81.CrossRefPubMed
15.
Brenner H, Chang-Claude J, Seiler CM, Sturmer T, Hoffmeister M. Potential for colorectal cancer prevention of sigmoidoscopy versus colonoscopy: population-based case control study. Cancer Epidemiol Biomarkers Prev. 2007;16(3):494–9.CrossRefPubMed
16.
Muller AD, Sonnenberg A. Protection by endoscopy against death from colorectal cancer. A case–control study among veterans. Arch Intern Med. 1995;155:1741–8.CrossRefPubMed
17.
Elmunzer BJ, Singal AG, Sussman JB, et al. Comparing the effectiveness of competing tests for reducing colorectal cancer mortality: a network meta-analysis. Gastrointest Endosc. 2015;81(3):700–9.CrossRefPubMedPubMedCentral
18.
Imperiale TF, Wagner DR, Lin CY, Larkin GN, Rogge JD, Ransohoff DF. Risk of advanced proximal neoplasms in asymptomatic adults according to the distal colorectal findings. N Engl J Med. 2000;343:169–74.CrossRefPubMed
19.
Lieberman DA, Weiss DG, Bond JH, Ahnen DJ, Garewal H, Chejfec G. Use of colonoscopy to screen asymptomatic adults for colorectal cancer. N Engl J Med. 2000;343:162–8.CrossRefPubMed
20.
Mandel JS, Church TR, Ederer F, Bond JH. Colorectal cancer mortality: effectiveness of biennial screening for fecal occult blood. J Natl Cancer Inst. 1999;91(5):434–7.CrossRefPubMed
21.•
Scholefield JH, Moss SM, Mangham CM, Whynes DK, Hardcastle JD. Nottingham trial of faecal occult blood testing for colorectal cancer: a 20-year follow-up. Gut. 2012;61:1036–40. Long-term data on a groundbreaking study in the area of colorectal cancer screening.
22.••
Aniwan S, Rerknimitr R, Kongkam P, Wisedopas N, Ponuthai Y, Chaithongrat S, et al. A combination of clinical risk stratification and fecal immunochemical test results to prioritize colonoscopy screening in asymptomatic participants. Gastrointest Endosc. 2015;81(3):719–27. An example of an excellent risk stratification model to increase the cost-effectiveness of colorectal cancer screening.CrossRefPubMed
23.
Hundt S, Haug U, Brenner H. Comparative evaluation if immunohistochemical fecal occult blood tests for colorectal adenoma detection. Ann Intern Med. 2009;150:162–9.CrossRefPubMed
24.
Park DI, Ryu S, Kim YH, et al. Comparison of guaiac-based and quantitative immunohistochemical fecal occult blood testing in a population at average risk undergoing colorectal cancer screening. Am J Gastroenterol. 2010;105:2017–25.CrossRefPubMed
25.
Wong MCS, Ching JYL, Chan VCW, et al. Diagnostic accuracy of a qualitative fecal immunohistochemical test varies with location of neoplasia but not number of specimens. Clin Gastroenterol Hepatol. 2015.
26.
Bleyer A, Welch HG. Effect of three decades of screening mammography on breast-cancer incidence. N Engl J Med. 2012;367:1998–2005.CrossRefPubMed
27.
Bjorkman D, Popp J. Measuring the quality of endoscopy. Gastrointest Endosc. 2006;63(Suppl):LS1–S2.CrossRef
28.
Faigel D, Pike I, Baron T, et al. Quality indicators for gastrointestinal endoscopic procedures: an introduction. Gastrointest Endosc. 2006;63(Suppl):S2–9.
29.
Rex D, Schoenfeld P, Cohen J, et al. Quality indicators for colonoscopy. Am J Gastroenterol. 2015;110:72–90.CrossRefPubMed
30.
Kaminski M, Regula J, Kraszewska E, et al. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med. 2010;362:1795–803.CrossRefPubMed
31.•
Corley D, Jensen C, Mrks A, et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med. 2014;370:1299801306. This article highlighted the association between low ADR and poor outcomes.CrossRef
32.
Rogal S, Pinsky P, Schoen R. Relationship between detection of adenomas by flexible sigmoidoscopy and interval distal colorectal cancer. Clin Gastroenterol Hepatol. 2013;11:73–8.CrossRefPubMed
33.
Rex D, Johnson D, Anderson J, et al. American College of Gastroenterology guidelines for colorectal cancer screening 2008. Am J Gastroenterol. 2009;104:739–50.CrossRefPubMed
34.
Baxter N, Sutradhar R, Forbes S, et al. Analysis of administrative data finds endoscopist quality measures associated with post-colonoscopy colorectal cancer. Gastroenterology. 2011;140:65–72.CrossRefPubMed
35.
Hosokawa O, Shirasaki S, Kaizaki Y, et al. Invasive colorectal cancer detected up to 3 years after a colonoscopy negative for cancer. Endoscopy. 2003;35:506–10.CrossRefPubMed
36.
Leaper M, Johnston M, Barclay M, et al. Reasons for failure to diagnose colorectal carcinoma at colonoscopy. Endoscopy. 2004;36:499–503.CrossRefPubMed
37.
Lee T, Rutter M, Blanks R, et al. Colonoscopy quality measures: experience from the NHS bowel cancer screening programme. Gut. 2012;61:1050–7.CrossRefPubMed
38.
Chen S, Rex D. Variable detection of non-adenomatous polyps by individual endoscopists at colonoscopy ad correlation with adenoma detection. J Clin Gastroenterol. 2008;42:704–7.CrossRefPubMed
39.
Rex D. Colonoscopic withdrawal technique is associated with adenoma miss rates. Gastrointest Endosc. 2000;51:33–6.CrossRefPubMed
40.
Lee R, Tang R, Muthusamy V, et al. Quality of colonoscopy withdrawal technique and variability in adenoma detection rates (with videos). Gastrointest Endosc. 2011;74:128–34.CrossRefPubMed
41.
Barclay R, Vicari J, Johanson J, et al. Variation in adenoma detection rates and colonoscopic withdrawal times during screening colonoscopy {abstract}. Gastrointest Endosc. 2005;61:AB107.CrossRef
42.
Sanchez W, Harewood G, Petersen B. Evaluation of polyp detection in relation to procedure time of screening or surveillance colonoscopy. Am J Gastroenterol. 2004;99:1941–5.CrossRefPubMed
43.
Fatima H, Rex D, Rothstein R, et al. Cecal insertion and withdrawal times with wide-angle versus standard colonoscopies: a randomized controlled trial. Clin Gastroenterol Hepatol. 2008;6:109–14.CrossRefPubMed
44.
Simmons D, Haregood G, Baron T, et al. Impact of endoscopist withdrawal speed on polyp yield: implications for optimal colonoscopy withdrawal time. Aliment Pharmacol Ther. 2006;24:965–71.CrossRefPubMed
45.
Lim G, Viney S, Chapman B, et al. A prospective study of endoscopist-blinded colonoscopy withdrawal times and polyp detection rates in a tertiary hospital. N Z Med J. 2012;125:52–9.PubMed
46.
Lin O, Kozarek R, Arai A, et al. The effect of periodic monitoring and feedback on screening colonoscopy withdrawal times, polyp detection rates, and patient satisfaction scores. Gastrointest Endosc. 2010;71:1253–9.CrossRefPubMed
47.
Johnson D, Barkun A, Coehn L, et al. Optimizing adequacy of bowel cleansing for colonoscopy: recommendations from the US Multi-Society Task Force on colorectal cancer. Am J Gastroenterol. 2014;109:1528–45.PubMed
48.
49.
Rostom A, Jolicoeur E. Validation of a new scale for the assessment of bowel preparation quality. Gastrointest Endosc. 2004;59:482–6.CrossRefPubMed
50.
Williams J, Le T, Faigel D. Polypectomy rate as a quality measure for colonoscopy. Gastrointest Endosc. 2011;73:498–506.CrossRefPubMed
51.
Williams J, Holub J, Faigel D. Polypectomy rate is a valid quality measure for colonoscopy: results from a national endoscopy database. Gastrointest Endosc. 2012;75:576–82.CrossRefPubMed
52.
Hilsden R, Rostom A, Dube C, et al. Is polyp detection rate a valid proxy for adenoma detection rate for measuring the technical quality of colonoscopy? Gastroenterology. 2010;138:S57.CrossRef
53.
Francis D, Rodriquez-Correa D, Buchner A, et al. Application of a conversion factor to estimate the adenoma detection rate from the polyp detection rate. Gastrointest Endosc. 2011;73:493–7.CrossRefPubMed
54.
Cooper G, Xu F, Barnholtz S, et al. Prevalence and predictors of interval colorectal cancers in Medicare beneficiaries. Cancer. 2012;118:3044–52.CrossRefPubMed
55.
Bressler B, Paszat L, Chen Z, et al. Rates of new or missed colorectal cancers after colonoscopy and their risk factors: a population-based analysis. Gastroenterology. 2007;132:96–102.CrossRefPubMed
56.
Robertson D, Lieberman D, Winawer S, et al. Interval cancer after total colonoscopy: results from a pooled analysis of eight studies. Gastroenterology. 2008;134:A-111.CrossRef
57.
Pohl H, Robertson D. Colorectal cancer detected after colonoscopy frequently result from missed lesions. Clin Gastroenterol Hepatol. 2010;8:858–64.CrossRefPubMed
58.
Brenner H, Chang-Claude J, Seiler C, et al. Interval cancers after negative colonoscopy: population-based case–control study. Gut. 2012;61:1576–82.CrossRefPubMed
59.
Singh H, Nugent Z, Mahmud S, et al. Predictors of colorectal cancer after negative colonoscopy: a population-based study. Am J Gastroenterol. 2010;105:663–73.CrossRefPubMed
60.
Limketkai B, Lam-Himlin D, Arnold M, et al. The cutting edge of serrated polyps: a practical guide to approaching and managing serrated colon polyps. Gastrointest Endosc. 2013;77:360–75.CrossRefPubMed
61.
Crockett S, Snover D, Ahnen D, Baron J. Sessile serrated adenomas: an evidence-based guide to management. Clin Gastroenterol Hepatol. 2015;13:11–26.CrossRefPubMed
62.
Tinmouth J, Henry P, Hsieh E, et al. Sessile serrated polyps at screening colonoscopy: have they been under diagnosed? Am J Gastroenterol. 2014;109:1698–704.CrossRefPubMed
63.•
Fayad N, Kahi C. Quality measures for colonoscopy: a critical evaluation. Clin Gastroenterol Hepatol. 2014;12:1973–80. This article highlights the strength and weaknesses of current quality indicators.CrossRefPubMed
64.
Kahi C, Hewett D, Norton D, et al. Prevalence and variable detection of proximal colon serrated polyps during screening colonoscopy. Clin Gastroenterol Hepatol. 2011;9:42–6.CrossRefPubMed
65.
Kahi C, Li X, Ecckekrt G, et al. High colonoscopic prevalence of proximal colon serrated polyps in average-risk men and women. Gastrointest Endosc. 2012;75:515–20.CrossRefPubMed
66.
Hetzel J, Huang C, Coukos J, et al. Variation in the detection of serrated polyps in an average risk colorectal cancer screening cohort. Am J Gastroenterol. 2010;105:2656–64.CrossRefPubMed
67.
Subramanian V, Mannath J, Hawkey C, et al. High definition colonoscopy vs. standard video endoscopy for the detection of colonic polyps: A meta-analysis. Endoscopy. 2011;43:499–505.CrossRefPubMed
68.
Kahi C, Anderson J, Waxman I, et al. High-definition chromocolonoscopy vs. high-definition white light colonoscopy for average-risk colorectal cancer screening. Am J Gastroenterol. 2010;105:1301–7.CrossRefPubMed
69.
De Wijkerslooth T, Stoop E, Bossuyt P, et al. Adenoma detection with cap-assisted colonoscopy versus regular colonoscopoy: a randomized controlled trial. Gut. 2012;61:1426–34.CrossRefPubMed
70.
Dinesen L, Chua T, Kaffes A. Meta-analysis of narrow-band imaging versus conventional colonoscopy for adenoma detection. Gastrointest Endosc. 2012;75:604–11.CrossRefPubMed
71.
Leufkens A, DeMarco D, Rastogi A, et al. Effect of a retrograde-viewing device on adenoma detection rate during colonoscopy: the TERRACE study. Gastrointest Endosc. 2011;73:480–9.CrossRefPubMed
72.
Gralnek I, Siiersema P, Halpern Z, et al. Standard forward-viewing colonoscopy versus full-spectrum endoscopy: an international, multicenter, randomized, tandem colonoscopy trial. Lancet Oncol. 2014;15:353–60.CrossRefPubMedPubMedCentral
73.
Gross S, Zamir H, Santo E, et al. A novel balloon-colonoscope for increased polyp/adenoma detection rate: results of a randomized tandem study. Am J Gastroenterol 108:S632–633.
74.
Biecker E, Floer M, Heinecke A, et al. The endocuff-assisted colonoscopy significantly increases the polyp and adenoma detection: results of a prospective randomized study with 498 patients. Oral presentation at DDW 2014, Chicago, IL.
75.
Centers for Disease Control and Prevention. Vital signs: colorectal cancer screening test use—United States, 2012. MMWR Morb Mortal Wkly Rep. 2013;62:881–8.
76.
von Karsa L, Anttila A, Ronco G, Ponti A, Malila N, Arbyn M, et al. Cancer screening in the European Union. Report on the implementation of the Council Recommendation on cancer screening—first report. ISBN 978-92-79-08934-3. European Communities (publ.) Printed in Luxembourg by the services of the European Commission. Lyon: IARC press; 2008.
77.
Guessous I, Dash C, Lapin P, et al. Colorectal cancer screening barriers and facilitators in older persons. Prev Med. 2010;50:3–10.CrossRefPubMed
78.
Bromley E, May F, Federer L, et al. Explaining persistent under-use of colonoscopic cancer screening in African Americans: a systematic review. Prev Med. 2015;71:40–8. A very relevant look at current barriers to screening in populations where colorectal cancer screening is underutilized.CrossRefPubMed
79.
Fidler H, Hartnett A, Cheng Man K, et al. Sex and familiarity of colonoscopists: patient preferences. Endoscopy. 2000;32:481–2.CrossRefPubMed
80.
Menees S, Inadomi J, Korsnes S, et al. Women patients’ preference for women physicians is a barrier to colon cancer screening. Gastrointest Endosc. 2005;62:219–23.CrossRefPubMed
81.
Varadarajulu S, Petruff C, Ramsey W. Patient preferences for gender of endoscopists. Gastrointest Endosc. 2002;56:170–3.CrossRefPubMed
82.
Denberg T, Kraus H, Soenksen A, et al. Rates of screening colonoscopy are not increased when women are offered a female endoscopist in a health promotion outreach program. Gastrointest Endosc. 2010;72:1014–9.CrossRefPubMed
83.
Bazargan M, Ani C, Bazargan-Hejazi S, et al. Coloreectal cancer screening among underserved minority population: discrepancy between physicians’ recommended, scheduled, and completed tests. Patient Educ Couns. 2009;76:240–7.CrossRefPubMed
84.
Carcaise-Edinboro P, Bradley C. Influence of patient-provider communication on colorectal cancer screening. Med Care. 2008;46:738–45.CrossRefPubMed
85.
Seeff L, Nadel M, Klabunde C, et al. Patterns and predictors of colorectal cancer test use in the adult U.S. population. Cancer. 2004;100:2093–103.CrossRefPubMed
86.
Laiyemo A, Adebogun A, Doubeni C, et al. Influence of provider discussion and specific recommendation on colorectal cancer screening uptake among U.S. adults. Prev Med. 2014;67:1–5.CrossRefPubMedPubMedCentral
87.
Inadomi J, Vijan S, Janz N, et al. Adherence to colorectal cancer screening: a randomized clinical trial of competing strategies. Arch Intern Med. 2012;172:575–82.CrossRefPubMedPubMedCentral
88.•
Kushnir VM, Oh YS, Hollander T, et al. Impact of retroflexion vs second forward view examination of the right colon on adenoma detection: a comparison study. Am J Gastroenterol. 2015;110(3):415–22. This study has the ability to strongly impact current colonoscopy techniques in order to increase the diagnostic yield of colonoscopy.CrossRefPubMedPubMedCentral
89.••
Imperiale TF, Monahan PO, Stump TE, et al. Derivation and validation of a scoring system to stratify risk for advanced colorectal neoplasia in asymptomatic adults. Ann Intern Med. 2015;163:339–46. This is an example of an excellent system that when implemented, can make current colorectal cancer screening methods more cost-effective.CrossRefPubMedPubMedCentral
90.
Stegeman I, Wijkerslooth TR, Stoop EM, et al. Combining risk factors with faecal immunochemical test outcome for selecting CRC screenees for colonoscopy. Gut. 2014;63:466–71.CrossRefPubMed
91.
Yeoh KG, Ho KY, Chiu HM, et al. The Asia-Pacific Colorectal Screening score: a validated tool that stratifies the risk for colorectal advanced neoplasia in asymptomatic Asian subjects. Gut. 2011;60:1236–41.CrossRefPubMed
92.••
Weinberg DS, Myers RE, Keenan E, Ruth K, Sifri R, Ziring B, et al. Genetic and environmental risk assessment and colorectal cancer screening in an average-risk population: a randomized trial. Ann Intern Med. 2014;161(8):527–45. This is an excellent example of an effective risk stratification model that can increase the cost effectiveness of current colorectal cancer screening modalities.CrossRef
93.
Myers RE, Ruth K, Manne SL, Cocroft J, Sifri R, Ziring B, et al. Effects of genetic and environmental risk assessment feedback on colorectal screening adherence. J Behav Med. 2015.
94.••
Baker DW, Brown T, Buchanan DR, et al. Comparative effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centers: a randomized clinical trial. JAMA Int Med. 2014;174(8):1235–41. This is a current and effective attempt to increase patient adherence to current colorectal cancer screening.CrossRef
95.
Anderson M. 6 facts about Americans and their smartphones. Pew Research Center: Internet, Science, and Tech; 2015.
96.
97.••
Kavathia N, Berggreen P, Gerkin R. Outcomes of smart phone application assisted bowel preparation for colonoscopy. Digestive Disease Week 2013. This is a very relevant and cutting edge implementation to capture a younger, more technologically advanced patient population in order to increase colorectal cancer screening adherence.
98.
Heitman SJ, Hilsden RJ, Au F, Dowden S, Manns BJ. Colorectal cancer screening for average-risk North Americans: an economic evaluation. PLoS Med. 2010;7(11), e1000370.CrossRefPubMedPubMedCentral
Metadata
Title
Colorectal Cancer Screening: a North American Point of View
Authors
Induruwa N. Pathirana
Dustin M. Albert
Patrick E. Young
Craig M. Womeldorph
Publication date
01-10-2016
Publisher
Springer US
Published in
Current Colorectal Cancer Reports / Issue 5/2016
Print ISSN: 1556-3790
Electronic ISSN: 1556-3804
DOI
https://doi.org/10.1007/s11888-016-0330-9

Other articles of this Issue 5/2016

Current Colorectal Cancer Reports 5/2016 Go to the issue

Colorectal Cancer Hepatic Metastases (MA Choti, Section Editor)

Use of Yttrium-90 Radioembolization for Management of Colorectal Liver Metastases

Adjuvant Therapy for Colon Cancers (AB Benson III and A de Gramont, Section Editors)

Findings from the Adjuvant Colon Cancer End Points (ACCENT) Collaborative Group: the Power of Pooled Individual Patient Data from Multiple Clinical Trials

Molecular Biology (S Mainardi, Section Editor)

Advancements in Modeling Colorectal Cancer in Rodents

Localized Colorectal Cancer (RD Kim, Section Editor)

Treatment of High Rectal Cancers: Do We Need Radiation?

Colorectal Cancer Hepatic Metastases (MA Choti, Section Editor)

Modern Technical Approaches in Hepatic Surgery for Colorectal Metastases

Therapeutic Approaches to Metastatic Colorectal Cancers (V Ricci, Section Editor)

Ramucirumab: a Novel Anti-Angiogenic Agent in the Treatment of Metastatic Colorectal Cancer
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits