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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 optic
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