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The case for universal screening colonoscopy.

The mortality related to colorectal malignancy each year remains significant. Although improvements in chemotherapy and surgical management may allow for some improvement, any profound impact must come through the implementation of appropriate screening. Several strategies for screening are available and widely practiced, but this review focuses on the concept of universal screening colonoscopy for the average-risk patient and addresses whether this is the appropriate recommendation in terms of safety, medicolegal, reimbursement and manpower issues, effectiveness and cost-effectiveness, patient acceptance, and appropriate intervals.