xColorectal cancer (CRC) is one of the leading causes of cancer deaths worldwide. This article reviews the aetiology and risk factors for CRC and focuses on strategies for prevention and early diagnosis. Prevention involves identifying and optimizing modifiable risk factors through public health awareness as well as population screening, for example using detection of occult blood in stool. Endoscopic surveillance in the UK is currently performed on a population basis with the bowel scope programme and faecal immunochemical testing, with colonoscopy reserved for patients known to be at higher risk of developing CRC.
The journal’s logo depicts the Rod of Asclepius crossed over a quill pen. The dates on the logo represent the founding of the components of the New England Journal of Medicine: 1812 for the New England Journal of Medicine and Surgery and Collateral Branches of Medical Science, 1823 for the Boston Medical Intelligencer, 1828 for the Boston Medical and Surgical Journal, and 1928 for the New England Journal of Medicine. 

The journal’s logo depicts the Rod of Asclepius crossed over a quill pen. The dates on the logo represent the founding of the components of the New England Journal of Medicine: 1812 for the New England Journal of Medicine and Surgery and Collateral Branches of Medical Science, 1823 for the Boston Medical Intelligencer, 1828 for the Boston Medical and Surgical Journal, and 1928 for the New England Journal of Medicine.
In April 2001, Druker et al. reported a targeted therapy for chronic myelogenous leukemia. Based on the knowledge that BCR-ABL, a constitutively activated tyrosine kinase, causes CML, the authors tested with success an inhibitor of this tyrosine kinase in patients who had failed first-line therapy. The finding helped begin the era of designing cancer drugs to target specific molecular abnormalities.[18]
A letter published in the NEJM in 1980 was later described by the journal as having been "heavily and uncritically cited"[14] to claim that addiction due to use of opioids was rare, and its publication in such an authoritative journal was used by pharmaceutical companies to push widespread use of opioid drugs, leading to an addiction crisis in the U.S. and other countries.[15]

In September 1811, John Collins Warren, a Boston physician,[2] along with James Jackson, submitted a formal prospectus to establish the New England Journal of Medicine and Surgery and Collateral Branches of Science as a medical and philosophical journal.[3] Subsequently, the first issue of the New England Journal of Medicine and Surgery and the Collateral Branches of Medical Science was published in January 1812.[4] The journal was published quarterly.
In September 1811, John Collins Warren, a Boston physician,[2] along with James Jackson, submitted a formal prospectus to establish the New England Journal of Medicine and Surgery and Collateral Branches of Science as a medical and philosophical journal.[3] Subsequently, the first issue of the New England Journal of Medicine and Surgery and the Collateral Branches of Medical Science was published in January 1812.[4] The journal was published quarterly.
Elsevier’s Medicine is a continually updated, evidence-based learning resource for trainees. It is an essential tool to help trainees achieve their postgraduate medical qualification, wherever you are in the world. It provides a concise overview of the latest medical knowledge and practice based upon the UK Core Medical Training curriculum, with each article written by invited qualified experts. Given its comprehensive coverage of internal medicine, this resource is also an ideal companion for GPs and consultants in the acute medicine setting.
Medicine covers internal medicine and all 13 of its sub-specialties, in addition to clinical topics such as poisoning, nutrition, ethics, communication skills, and clinical pharmacology. Irrespective of your medical specialty, Medicine provides you with access to trusted information on mechanisms of disease, diagnosis and management options. With the core information provided in this singular resource, you can focus on being a confident and competent physician.
Elsevier’s Medicine is a continually updated, evidence-based learning resource for trainees. It is an essential tool to help trainees achieve their postgraduate medical qualification, wherever you are in the world. It provides a concise overview of the latest medical knowledge and practice based upon the UK Core Medical Training curriculum, with each article written by invited qualified experts. Given its comprehensive coverage of internal medicine, this resource is also an ideal companion for GPs and consultants in the acute medicine setting.
xColorectal cancer (CRC) is common, affecting >40,000 people a year in the UK. Most cancers are sporadic but a few, such as those occurring at a younger age, have a clear genetic basis. Most are situated in the rectum or rectosigmoid and cause rectal bleeding, often with a looser or more frequent stool. Right-sided cancers typically result in anaemia, because the blood in the stool is occult and unnoticed by the patient. Almost all symptoms of malignancy can also be caused by benign disease. Diagnosis relies on luminal imaging, with colonoscopy being the gold standard.
The journal’s logo depicts the Rod of Asclepius crossed over a quill pen. The dates on the logo represent the founding of the components of the New England Journal of Medicine: 1812 for the New England Journal of Medicine and Surgery and Collateral Branches of Medical Science, 1823 for the Boston Medical Intelligencer, 1828 for the Boston Medical and Surgical Journal, and 1928 for the New England Journal of Medicine.

In June 1948, Sidney Farber reported promising results in treatment of early childhood leukemia. Based on anecdotal evidence that children with acute leukemia worsened if they were given folic acid, he worked on blocking folic acid metabolism. His team gave 16 infants and children with acute lymphoblastic leukemia a folic acid inhibitor, aminopterin—10 showed improvement by clinical and hematologic parameters after three months.[11] In his article, Farber advised receiving the results cautiously: "It is again emphasized that these remissions are temporary in character and that the substance is toxic and may be productive of even greater disturbances than have been encountered so far in our studies," he wrote. "No evidence has been mentioned in this report that would justify the suggestion of the term 'cure' of acute leukemia in children."


In April 2001, Druker et al. reported a targeted therapy for chronic myelogenous leukemia. Based on the knowledge that BCR-ABL, a constitutively activated tyrosine kinase, causes CML, the authors tested with success an inhibitor of this tyrosine kinase in patients who had failed first-line therapy. The finding helped begin the era of designing cancer drugs to target specific molecular abnormalities.[18]
In September 1811, John Collins Warren, a Boston physician,[2] along with James Jackson, submitted a formal prospectus to establish the New England Journal of Medicine and Surgery and Collateral Branches of Science as a medical and philosophical journal.[3] Subsequently, the first issue of the New England Journal of Medicine and Surgery and the Collateral Branches of Medical Science was published in January 1812.[4] The journal was published quarterly.

xColorectal cancer (CRC) is common, affecting >40,000 people a year in the UK. Most cancers are sporadic but a few, such as those occurring at a younger age, have a clear genetic basis. Most are situated in the rectum or rectosigmoid and cause rectal bleeding, often with a looser or more frequent stool. Right-sided cancers typically result in anaemia, because the blood in the stool is occult and unnoticed by the patient. Almost all symptoms of malignancy can also be caused by benign disease. Diagnosis relies on luminal imaging, with colonoscopy being the gold standard.


In September 1811, John Collins Warren, a Boston physician,[2] along with James Jackson, submitted a formal prospectus to establish the New England Journal of Medicine and Surgery and Collateral Branches of Science as a medical and philosophical journal.[3] Subsequently, the first issue of the New England Journal of Medicine and Surgery and the Collateral Branches of Medical Science was published in January 1812.[4] The journal was published quarterly. 

In the early 2000s, the New England Journal of Medicine was involved in a controversy around problems with research on the drug Vioxx. A study was published in the journal in November 2000 which noted an increase in myocardial infarction amongst those taking Vioxx.[27] According to Richard Smith, the former editor of the British Medical Journal, concerns about the correctness of that study were raised with the journal's editor, Jeff Drazen, as early as August 2001. That year, both the US Food and Drug Administration and the Journal of the American Medical Association also cast doubt on the validity of the data interpretation that had been published in the NEJM.[28] Merck withdrew the drug from market in September 2004. In December 2005, NEJM published an expression of concern about the original study following discovery that the authors knew more about certain adverse events than they disclosed at the time of publication. From the Expression of Concern: "Until the end of November 2005, we believed that these were late events that were not known to the authors in time to be included in the article published in the Journal on November 23, 2000. It now appears, however, from a memorandum dated July 5, 2000, that was obtained by subpoena in the Vioxx litigation and made available to the Journal, that at least two of the authors knew about the three additional myocardial infarctions at least two weeks before the authors submitted the first of two revisions and 4 1/2 months before publication of the article."[29] During the five-year period between publication and Expression of Concern, it has been estimated that Merck paid NEJM as much as US$836,000 for article reprints that Merck used for promotional purposes.[30] The journal was publicly rebuked for its response to the research issues in editorials appearing in publications including the British Medical Journal[28] and the Journal of the Royal Society of Medicine.[31]
Elsevier’s Medicine is a continually updated, evidence-based learning resource for trainees. It is an essential tool to help trainees achieve their postgraduate medical qualification, wherever you are in the world. It provides a concise overview of the latest medical knowledge and practice based upon the UK Core Medical Training curriculum, with each article written by invited qualified experts. Given its comprehensive coverage of internal medicine, this resource is also an ideal companion for GPs and consultants in the acute medicine setting.
In September 1811, John Collins Warren, a Boston physician,[2] along with James Jackson, submitted a formal prospectus to establish the New England Journal of Medicine and Surgery and Collateral Branches of Science as a medical and philosophical journal.[3] Subsequently, the first issue of the New England Journal of Medicine and Surgery and the Collateral Branches of Medical Science was published in January 1812.[4] The journal was published quarterly.
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