Precision Medicine Versus Population Medicine in Colon Cancer: From Prospects of Prevention, Adjuvant Chemotherapy, and Surveillance

Approximately one in 20 Americans will develop colorectal cancer (CRC) in their lifetimes.1 Population CRC prevention by screening colonoscopy for average-risk individuals begins at age 50 and generally is repeated every 10 years.2-4 Precision CRC prevention connotes a tailored approach to screening for CRC, in which the differential use of preventive strategies like colonoscopy or chemoprevention are based on individual and/or group-specific risks. Although much of the practice of medicine is still conducted in a one-size-fits-all fashion, increasing costs and growing recognition of variability in cancer risk that results from measurable genetic risk factors and adverse environmental, dietary, or occupational exposures have fueled the development of guidelines in preventive oncology that help clinicians stratify patients by risk in an effort to optimize screening and prevention.2,3,5 The growing and increasingly complex list of personal history, family history, and genetic risk factors that are now included in many guideline statements are evidence of the centrality of precision in current CRC prevention practices and will be the focus of this discussion. PREVENTION Section: ChooseTop of pageAbstractPREVENTION <