Navigation Links
New Colon Cancer Screening Guidelines Focus on Individual Risk
Date:3/6/2012

By Carina Storrs
HealthDay Reporter

MONDAY, March 5 (HealthDay News) -- New guidelines for colorectal cancer screening from the American College of Physicians (ACP) put the emphasis on individual risk.

People at average risk of developing colorectal cancer should get screened starting at age 50, whereas people at high risk -- those with inflammatory bowel disease or a personal or family history of the disease -- should get screened starting at age 40 or earlier, according to the updated recommendations. The guidelines appear in the March 6 issue of the Annals of Internal Medicine. March is U.S. National Colorectal Cancer Awareness Month.

In arriving at the new guidelines, the ACP evaluated the quality of colorectal cancer screening guidelines from many medical organizations to develop a "take-home message" both to help physicians make decisions and to help patients discuss screenings with their doctor, explained Dr. Amir Qaseem, director of clinical policy for the ACP and lead author of the guidelines.

"I think we are recommending something that the majority of organizations do: a risk assessment of people to see if they need to be screened earlier than 50 and for doctors to talk about the options," Qaseem said.

The guidelines recommend several screening options for average-risk patients: optical colonoscopy or flexible sigmoidoscopy, both of which involve inserting a narrow tube with a camera into the rectum, or stool sample tests.

All of these tests are thought to be similarly effective at preventing colorectal cancer-related death for average-risk patients, so the ACP decided that the choice of which to use should come down to factors such as patients' personal preferences and how well they are expected to tolerate the tests.

"Each has their benefits and harms," Qaseem said. The risk of bleeding and puncture of the colon may be higher in certain patients with invasive tests like optical colonoscopy and flexible sigmoidoscopy.

High-risk patients, on the other hand, should have an optical colonoscopy, which is the most sensitive test and the only one of the recommended tests that examines the entire colon.

Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Although screening can prevent deaths, only about 60 percent of adults aged 50 years and older in the United States get screened.

The fact that patients have many screening tests from which to choose will hopefully allow them to find one with which they are comfortable, Qaseem said.

"The ACP did a good service in developing a consensus guideline," said Dr. Frank Sinicrope, a professor of medicine and oncology at the Mayo Clinic in Rochester, Minn. "It's one source that internists and other physicians can go to."

Although other guidelines have included the importance of individual risk assessment, not all of them have embraced it, Sinicrope added. "We like to figure out who is average risk -- most of the patients -- and make a recommendation for them," he said. "[We] also consider higher risk [patients] who need a different recommendation."

People with a first-degree relative (parents, siblings, or children) who was diagnosed with colorectal cancer are at increased risk, and should start getting screened either at age 40 or 10 years before the age at which their relative was diagnosed, whichever comes first, according to the guidelines. Black people could also be at increased risk of developing colorectal cancer.

Getting a patient's family history is important for doctors to remember to do, Sinicrope said. "Family history data is elicited less frequently and is really not as detailed to do this properly," he said.

The guidelines also advise against screening people who are over 75 years old or who have a life expectancy of less than 10 more years because they are more likely to die of causes other than colorectal cancer, which takes a while to progress.

This is another instance where each patient should be assessed individually, however. "Some people at 75 may be healthier than some at 55, and you have to make a clinical judgment," Qaseem said. "In those patients it may be OK [to screen], because they may be living to 100."

The decision of which screening test to use also depends on what doctors feel comfortable with, Sinicrope said.

Although there is evidence to support using a newer form of noninvasive colonoscopy, called CT or virtual, colonoscopy, Sinicrope said there are not enough doctors who have expertise with the technology for it to be reliable. The ACP guidelines did not recommend CT colonoscopy.

In all, the ACP panel reviewed guidelines from five organizations that each focused on different aspects of screening: the U.S. Preventive Services Task Force, the Institute for Clinical Systems Improvement, the American College of Radiology, the American College of Gastroenterology, and the joint guidelines by the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology.

More information

Find out more about colon cancer at the American Cancer Society.

SOURCES: Amir Qaseem, M.D., director, clinical policy, American College of Physicians; Frank Sinicrope, M.D., professor, medicine and oncology, Mayo Clinic, Rochester, Minn.; March 6, 2012, Annals of Internal Medicine


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Racial disparities persist in the diagnosis of advanced breast cancer and colon cancer in the U.S.
2. New SeaColonyTennis.net Launches to Promote World-Class Tennis Programs at Sea Colony
3. President Obama Gets Virtual Colonoscopy (CT Colonography) But Medicare Denies CTC Coverage to Seniors
4. Proteins May Predict Spread of Colon Cancer
5. Obese Colon Cancer Survivors Face Poorer Prognosis
6. Obesity linked to poor colon cancer prognosis
7. Study evaluates costs and benefits associated with new colon cancer therapies
8. Older Colon Cancer Patients Less Likely to Get Chemo
9. Colonoscopy Not Needed for Most With Irritable Bowel Syndrome
10. Studies examine Third Eye Retroscope during colonoscopy
11. Virtual colonoscopy allows detection of unsuspected cancers beyond colon
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
New Colon Cancer Screening Guidelines Focus on Individual Risk
(Date:2/10/2016)... (PRWEB) , ... February 10, 2016 , ... Ongoing news ... Aging Life Care Association™ (ALCA) to conduct a survey that takes a closer look ... released today illustrates the prevalence and causes of TBI among the aging population, and ...
(Date:2/10/2016)... ... February 10, 2016 , ... AxoGen, Inc. (NASDAQ: AXGN), a ... for the fourth quarter and full year ended December 31, 2015 on Monday, February ... and webcast for the investment community following the release at 4:30 PM ET. Investors ...
(Date:2/10/2016)... ... ... For additional information contact Phyllis Strupp 480-488-5858 , Brain improves with age, ... Guide to Brain Training" by award-winning author Phyllis Strupp explains how brain ... 16, 2016. A free review copy is available to the media at NetGalley ...
(Date:2/10/2016)... ... 2016 , ... IDEX Health & Science, LLC announces the ... columns combine the strength of traditional stainless steel with the chemical inertness of ... operating at ultra-high pressures of 20,000 psi. The higher operating pressures allow faster ...
(Date:2/10/2016)... (PRWEB) , ... February 10, 2016 , ... The recreational ... cannabis enthusiasts in the state still face a lot of restrictions as to where ... is intended for private, personal use” and that cannabis “may not be consumed openly ...
Breaking Medicine News(10 mins):
(Date:2/10/2016)... Health, Inc. (Nasdaq: GHDX ) today reported financial results ... 2015. --> --> Revenue was ... million in the fourth quarter of 2014, an increase of 8 ... with the same period in the prior year. ... the fourth quarter of 2015, an increase of 9 percent compared ...
(Date:2/10/2016)... LEXINGTON, Massachusetts , February 10, 2016 --> ... Japan .  --> Japan .  ... Japan .  With submission, Shire continues to ... --> With submission, Shire continues to ... With submission, Shire continues to strengthen ...
(Date:2/10/2016)... and SAN DIEGO , Feb. ... a global leader in viral gene therapy manufacturing, and ... for congestive heart failure and other chronic diseases, have ... scalable manufacturing process and produce cGMP-grade RT-100 (Ad5.hAC6) Drug ... --> --> This ...
Breaking Medicine Technology: