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Colorectal Cancer
  1. J H Scholefield

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My initial reaction to a single author text on colorectal cancer was that the author was either a brave or a foolish man to attempt such an onerous task single handed. New information about aetiology, screening, pathogenesis, and all aspects of treatment have changed considerably in the last 10 years and the literature abounds with new information, only some of which is important, but all of it needs sifting to distil a worthwhile and up to date text.

The synopsis claims this text to be an “updated and comprehensive description of the most relevant features of colorectal cancer . . .”—I beg to differ.

In the preface, Dr de Leon states that he hopes the volume captures his spirit of the constructive and critical attitude which may help a new generation of investigators, and to some extent the volume has achieved this aim. However, he also recognises his own limitations in taking on this daunting task

The author is not explicit as to who the book is aimed at but refers to a “new generation of investigators”—if this means that the book is aimed at giving an overview of colorectal cancer to people working in basic science on colorectal cancer then the book is short enough to be digestible. As an overview of colorectal cancer in the 21st century, a single author could not be expected to do justice to the whole topic and this text is not a comprehensive overview of colorectal cancer.

The best sections of the book are not surprisingly those areas which Dr de Leon has written and published on himself, namely the genetics of colorectal cancer and chemoprevention of colorectal cancer. In many respects the excellent description of the state of the art in these areas highlights the inadequacies in other areas such as pathology, surgical technique, mesorectal excision, adjuvant chemotherapy, and the role of radiotherapy, which are covered in a superficial manner. With the exception of the genetics of colorectal cancer, the reviews of the literature are brief and highly selected. The section on adjuvant chemotherapy and the data presented on faecal occult blood screening are far too brief to do them justice given the current interest worldwide in these aspects of the disease. The section on screening by endoscopic means makes no mention of the potential complications of this modality, and surely deserves at least a mention. Unfortunately, there are also some inaccuracies in the book—for example, the section on screening by CT colography.

The book is written in a very readable style but with very few illustrations and the quality of the illustrations included is adequate. I found the lack of detail and lack of inclusion of some of the most relevant literature (the last five years) irritating and frustrating. Given the size of the task, I imagine such a book was several years in gestation and this may account for some recent important publications being omitted. It is certainly not a reference book but might provide useful background reading for investigators who are new to the area.