Q&A ACP Issues New Guidance on Colorectal Cancer Screening
Q&A: ACP issues new guidance on colorectal cancer screening
The ACP has issued a new evidence-based guidance statement on screening for colorectal cancer screening in asymptomatic adults with average risk.
Because multiple organizations differ on recommendations for screening age, methods and screening intervals, the “ACP offers guidance that attempts to reconcile the different guidelines,” Michael Pignone, MD, MPH, chair of the department of medicine in the Dell Medical School at the University of Texas, wrote in an accompanying editorial.
The authors of the ACP guidance statement said they evaluated cancer screening guidelines published by U.S. organizations between June 2014 and May 2018. ACP guidance statements are based on evidence used and referenced in the guidelines that scored the highest in their clinical appraisal, and do not include new findings. They arrived at their own recommendations based primarily on the U.S. Preventive Services Task Force and Canadian Task Force on Preventive Health Care guidelines.
The ACP recommends that average-risk adults should be screened between 50 and 75 years of age; that clinicians discuss the harms and benefits of different screening methods with patients; and that clinicians stop screening for colorectal cancer in average-risk patients aged older than 75 years or patients who have a life expectancy of less than 10 years.
Doctor consulting with patient
The ACP has issued a new evidence-based guidance statement on screening for colorectal cancer screening in asymptomatic adults with average risk.
Source: Adobe Stock
Amir Qaseem, MD, PhD, MHA, lead author of the guidance statement and vice president of clinical policy at ACP, discussed the recommendations with Healio Primary Care. – by Erin Michael
Q: Why is the ACP guidance for colorectal cancer screening in asymptomatic average-risk adults based primarily on USPSTF and Canadian Task Force on Preventive Health Care (CTFPHC) guidelines?
A: We reviewed and evaluated available guidelines using the AGREE (Appraisal of Guidelines for Research and Evaluation) instrument. We selected two guidelines — CTFPHC and USPSTF — as they scored highest overall. Differences between high and low scoring guidelines were mostly due to methodological rigor and editorial independence. According to the National Academy of Medicine and the Guidelines International Network, a rigorous and high-quality process is a critical component of a trustworthy guideline.
Q: What is the importance of discussing colorectal cancer screening test options with patients?
A: Colorectal cancer is the second leading cause of cancer-related death in both men and women in the United States. Considering that the screening rates in the eligible population are hovering around mid-60%, it is critical to increase screening to reduce overall and cancer-specific mortality and morbidity.