Colorectal cancer screening guidelines update

A new guideline on colorectal cancer screening released by an expert group representing a broad spectrum of health care organizations, including the American College of Gastroenterology (ACG), the American Society for Gastrointestinal Endoscopy (ASGE) and the American Cancer Society (ACS), offers recommendations for various alternatives for colorectal cancer detection and states a strong preference for screening tests that can prevent colorectal cancer.

The ASGE and the ACG are members of the U.S. Multi-Society Task Force on Colorectal Cancer and were participants in the guideline development process.

“What distinguishes these new guidelines is an emphasis on the importance and value of preventing colorectal cancer, which GI physicians applaud,” said Amy E. Foxx-Orenstein, D.O., FACG, president of the ACG.

“We know that 50 percent of Americans who should be getting screening for this largely preventable disease are not,” said Grace H. Elta, M.D., FASGE, president of the ASGE. “The data show that screening saves lives and efforts to increase colon cancer awareness and screening will help patients through earlier detection.”

Both the ASGE and the ACG want the public to be aware that the guideline’s stated preference for tests that prevent colorectal cancer supports the groups’ longstanding positions that colonoscopy is the preferred screening strategy for colorectal cancer. Because of its excellent sensitivity in detecting polyps and its potential for removing them and breaking the sequence of polyp to cancer in a single diagnostic and therapeutic intervention, colonoscopy is one of the most powerful preventive tools in clinical medicine.

Several tests are among the recommended alternatives including stool tests that detect colorectal cancer but not its precursor, colon polyps, and structural examinations of the colon by endoscopic procedures such as flexible sigmoidoscopy and colonoscopy, as well as radiological examinations by either barium enema or CT colonography, also known as “virtual colonoscopy.” The new guideline recognizes that for flexible sigmoidoscopy, barium enema and CT colonography, a follow-up colonoscopy will be required if anything suspicious is discovered.

Dr. Foxx-Orenstein of ACG added, “All of us on the front lines of battling colorectal cancer welcome this thorough review of the evidence regarding all the various screening modalities. While the evidence suggests that there are some limitations to all of the tests, the College sees significant strengths in the proven benefits of visualizing pre-cancerous growths and removing them in a single examination during colonoscopy.”

According ACG’s Dr. Foxx-Orenstein, “We congratulate the American Cancer Society and the other group participants on the publication of these guidelines which required so much collegiality and scientific exchange to navigate areas where clinically there still exists much controversy and uncertainty.”

Dr. Elta added, “It is our greatest hope that these new guidelines will contribute to the increased use of colorectal cancer screening tests to reduce the incidence of colorectal cancer, and thereby save lives.”

Source: American College of Gastroenterology, USA



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