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

al 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 colo
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