Key Points
➤ This pocket guide focuses on the role of the early detection of colorectal
cancer and the management of any polyps found during colorectal cancer
screening among those at average risk, as well as the workup and diagnosis
of colorectal cancer.
➤ Different regions of the world differ with respect to access to early
detection.
• Very few locations outside of high-income countries (HICs) have mass or even
opportunistic screening. Even within countries/regions, variations occur between rural
and urban and between areas with basic primary care and better-resourced medical care
not available in the local area but rather further away.
Table 1. Framework of Resource Stratification
Setting
Basic Core resources or fundamental services that are absolutely necessary for any
public health/primary health care system to function; basic-level services
typically are applied in a single clinical interaction.
Limited Second-tier resources or services that are intended to produce major
improvements in outcome such as incidence and cost-effectiveness and are
attainable with limited financial means and modest infrastructure; limited-
level services may involve single or multiple interactions. Universal public
health interventions feasible for greater percentage of population than
primary target group.
Enhanced ird-tier resources or services that are optional but important; enhanced-
level resources should produce further improvements in outcome and increase
the number and quality of options and individual choice. (Perhaps ability to
track patients and links to registries).
Maximal May use high-resource settings' guidelines.
High-level/state-of-the art resources or services that may be used/available
in some high-resource countries and/or may be recommended by high-
resource setting guidelines that do not adapt to resource constraints but
that nonetheless should be considered a lower priority than those resources
or services listed in the other categories on the basis of extreme cost and/or
impracticality for broad use in a resource-limited environment.
NOTE: Data adapted. To be useful, maximal-level resources typically depend on the existence
and functionality of all lower level resources.
Treatment