American College Of Physicians (ACP) Updates Guidance For Colorectal Cancer Screening Due To Growing Incidence Rates
As a result of a growing incidence rate of colorectal cancer
in the US and also globally, the American College of Physicians (ACP) has issued new revised guidelines that has been published in the Annals Of Internal Medicine.
The guidelines states that doctors should screen for colorectal cancer
in average-risk adults who do not have symptoms between the ages of 50 and 75. The frequency of screening depends upon the screening approach selected. ACP suggests any one of the following screening strategies:
1.Fecal immunochemical test (FIT) or high sensitivity guaiac-based fecal occult blood test (gFOBT) every two years
2.Colonoscopy every 10 years
3.Flexible sigmoidoscopy every 10 years plus FIT every two years
ACP President Dr Robert M. McLean, MD, MACP commented in a phone interview with Thailand Medical
News, "Not enough people in the United States get screened for colorectal cancer
and the issue is even worse in other countries. Doctors 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."
The new ACP guidelines are 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.
Though 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, ACP found.
Unfortunately, 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.
Currently, colorectal cancer
is the second leading cause of cancer -related mortality in men and in women in the United States and also in the world. The age to start and stop screening, screening intervals, and the recommended screening test differ among organizations. Different organizations have dif
ferent criteria for evaluating or assessing the quality and certainty of evidence, follow different processes for creating clinical recommendations, and can interpret the evidence differently.
Instead of developing a new clinical practice guideline in such circumstances ACP instead prepares and releases guidance statements that rely on evidence presented or referenced in selected guidelines and accompanying evidence reports. ACP guidance statements do not include new reviews or searches of the literature outside the body of evidence referenced by the reviewed guidelines.
In the published guidelines: "Screening for Colorectal Cancer
in Asymptomatic Average Risk Adults," ACP 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
Members if the public are strongly advised that even if you do no fall in the targeted age group but still suffer certain symptoms or suspect that you might have colorectal cancer
, immediately consult a doctor and make an appointment for screening. The incidence for colorectal cancer
is not just increasing in the targeted age groups but also in the younger adults.
Reference: Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults: A Guidance Statement From the American College of Physicians, Amir Qaseem, MD, PhD, MHA; Carolyn J. Crandall, MD, MS; Reem A. Mustafa, MD, MPH, PhD; Lauri A. Hicks, DO; Timothy J. Wilt, MD, MPH *; for the Clinical Guidelines Committee of the American College of Physicians, Annals Of Internal Medicine