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      Korean Guidelines for Colorectal Cancer Screening and Polyp Detection

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          Abstract

          Now colorectal cancer is the second most common cancer in males and the fourth most common cancer in females in Korea. Since most of colorectal cancers occur after the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are one of the most effective methods to prevent colorectal cancer. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish Korean guideline for colorectal cancer screening and polyp detection. The guideline was developed by the Korean Multi-Society Take Force and we tried to establish the guideline by evidence-based methods. Parts of the statements were draw by systematic reviews and meta-analyses. Herein we discussed epidemiology of colorectal cancers and adenomas in Korea and optimal methods for screening of colorectal cancer and detection of adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations.

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          Most cited references 143

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          GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.

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            Grading quality of evidence and strength of recommendations.

            Users of clinical practice guidelines and other recommendations need to know how much confidence they can place in the recommendations. Systematic and explicit methods of making judgments can reduce errors and improve communication. We have developed a system for grading the quality of evidence and the strength of recommendations that can be applied across a wide range of interventions and contexts. In this article we present a summary of our approach from the perspective of a guideline user. Judgments about the strength of a recommendation require consideration of the balance between benefits and harms, the quality of the evidence, translation of the evidence into specific circumstances, and the certainty of the baseline risk. It is also important to consider costs (resource utilisation) before making a recommendation. Inconsistencies among systems for grading the quality of evidence and the strength of recommendations reduce their potential to facilitate critical appraisal and improve communication of these judgments. Our system for guiding these complex judgments balances the need for simplicity with the need for full and transparent consideration of all important issues.
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              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.

              In the United States, colorectal cancer (CRC) is the third most common cancer diagnosed among men and women and the second leading cause of death from cancer. CRC largely can be prevented by the detection and removal of adenomatous polyps, and survival is significantly better when CRC is diagnosed while still localized. In 2006 to 2007, the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology came together to develop consensus guidelines for the detection of adenomatous polyps and CRC in asymptomatic average-risk adults. In this update of each organization's guidelines, screening tests are grouped into those that primarily detect cancer early and those that can detect cancer early and also can detect adenomatous polyps, thus providing a greater potential for prevention through polypectomy. When possible, clinicians should make patients aware of the full range of screening options, but at a minimum they should be prepared to offer patients a choice between a screening test that primarily is effective at early cancer detection and a screening test that is effective at both early cancer detection and cancer prevention through the detection and removal of polyps. It is the strong opinion of these 3 organizations that colon cancer prevention should be the primary goal of screening.
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                Author and article information

                Journal
                Clin Endosc
                Clin Endosc
                CE
                Clinical Endoscopy
                The Korean Society of Gastrointestinal Endoscopy
                2234-2400
                2234-2443
                March 2012
                31 March 2012
                : 45
                : 1
                : 25-43
                Affiliations
                [1 ]Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
                [2 ]Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
                [3 ]Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
                [4 ]Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
                [5 ]Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
                [6 ]Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
                [7 ]Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.
                [8 ]Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea.
                [9 ]Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
                [10 ]Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
                [11 ]Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.
                [12 ]Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
                [13 ]Department of Radiology, Konkuk University School of Medicine, Seoul, Korea.
                Author notes
                Correspondence: Hyun-Soo Kim. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 220-701, Korea. Tel: +82-33-741-1229, Fax: +82-33-741-1228, hyskim@ 123456yonsei.ac.kr
                Article
                10.5946/ce.2012.45.1.25
                3363119
                22741131
                Copyright © 2012 The Korean Society of Gastrointestinal Endoscopy

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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