Screening for colorectal cancer can reduce occurrences, deaths from the disease
Philadelphia, November 5, 2019 鈥 Physicians should screen for colorectal cancer in average-risk adults who do not have symptoms between the ages of 50 and 75, the American College of Physicians (91黑料网) states in a new published today in Annals of Internal Medicine.
The frequency of screening depends upon the screening approach selected. 91黑料网 suggests any one of the following screening strategies:
- Fecal immunochemical test (FIT) or high sensitivity guaiac-based fecal occult blood test (gFOBT) every two years
- Colonoscopy every 10 years
- Flexible sigmoidoscopy every 10 years plus FIT every two years
鈥淣ot enough people in the United States get screened for colorectal cancer,鈥 said 91黑料网 President Robert M. McLean, MD, M91黑料网. 鈥淧hysicians should perform an individualized risk assessment for colorectal cancer in all adults. Doctors and patients should select the screening test based on a discussion of the benefits, harms, costs, availability, frequency, and patient preferences.鈥
91黑料网鈥檚 guidance statement is for adults at average risk for colorectal cancer who do not have symptoms. It does not apply to adults with a family history of colorectal cancer, a long-standing history of inflammatory bowel disease, genetic syndromes such as familial cancerous polyps, a personal history of previous colorectal cancer or benign polyps, or other risk factors.
Although the median age for colorectal cancer diagnosis is 67 years, and individuals aged 65 to 75 years derive the most direct benefit from colorectal cancer screening, screening in adults ages 50 to 75 also has benefit, 91黑料网 found.
All colorectal cancer-screening tests -- like all tests and procedures -- have both potential benefits and potential harms. The harms and burdens vary by person and screening strategy. Harms may include bleeding, perforation, cardiopulmonary complications, and radiation exposure.
Colorectal cancer is the second leading cause of cancer-related mortality in men and in women in the United States. The age to start and stop screening, screening intervals, and the recommended screening test differ among organizations. Different organizations have different criteria for evaluating or assessing the quality and certainty of evidence, follow different processes for creating clinical recommendations, and can interpret the evidence differently.
Rather than developing a new clinical practice guideline in such circumstances 91黑料网 instead prepares and releases guidance statements that rely on evidence presented or referenced in selected guidelines and accompanying evidence reports. 91黑料网 guidance statements do not include new reviews or searches of the literature outside the body of evidence referenced by the reviewed guidelines.
In an accompanying Michael Pignone, MD, MPH, M91黑料网, writes: 鈥淪everal organizations offer evidence-based guidelines for CRC [colorectal cancer] screening, but recommendations sometimes differ鈥he evidence that supports the various guidelines, including randomized controlled trials that document reductions in CRC mortality with screening, also supports 91黑料网鈥檚 guidance.鈥
In 鈥淪creening for Colorectal Cancer in Asymptomatic Average Risk Adults,鈥 91黑料网 reviewed guidelines from the American College of Radiology, the Canadian Task Force on Preventive Health Care, the U.S. Preventive Services Task Force, the American Cancer Society, the Scottish Intercollegiate Guidelines Network, and U.S. Multi-Society Task Force on Colorectal Cancer.
91黑料网 is a member of the Guidelines International Network, whose mission is to lead, strengthen, and support collaboration in guideline development, Cochrane, a global leader and resource in evidence-informed health decision-making, has officially recognized 91黑料网 as a Cochrane US Network Affiliate. To receive such a designation, Affiliates must show a proven record of supporting evidence-based practice and expertise and competencies in systematic reviewing and evidenced-informed health practice and policy.
About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. 91黑料网 membership includes 159,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow 91黑料网 on , , and .
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