Colorectal cancer (CRC) is one of the most common malignancies in the United States and affects nearly 150 000 individuals per year.1 The prognosis for patients with CRC is directly related to their stage at diagnosis, with 5-year survival greater than 90% for the rare patient diagnosed with stage I cancer but less than 5% for patients with metastatic disease.2 Therefore, early diagnosis is essential for the prevention of the morbidity and mortality associated with CRC. This fact underlies the current recommendations for population-based screening for colon polyps and cancer, preferably using colonoscopy in individuals 50 years or older.3 Diet and lifestyle factors are thought to influence risk for CRC in the general population, but family history also clearly affects the individual risk for CRC, presumably due to genetic factors.
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The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
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