Screening and early diagnosis of colorectal cancer

What should an ideal screening and surveillance colonoscopy be able to accomplish ? The technique should allow detection of large but also discrete mucosal alterations. ideally, endoscopic discrimination between neoplastic and non-neoplastic lesions would be possible during the ongoing procedure. At present, endoscopy can be performed with new powerful endoscopes. Comparably to the rapid development in chip technology, the optic,features of the newly designed endoscopes offer resolutions which allow new surface details to be seen. In conjunction with chromoendoscopy, the newly discovered tool video colonoscopy is much easier and more impressive today than with the previously used fiberoptic endoscopes. Recently, new endoscopic technologies like narrow band imaging, endocytoscopy, or confocal laser endoscopy have allowed for discovering a whole new world of image details, which will surely improve the diagnostic yield in the field of early malignancies. This review summarizes newly available technologies and clinical data about the diagnosis of early lower gastrointestinal cancers.