Author Archives

Why Colon Cancer?

Colorectal cancer is preventable, treatable, and beatable. Colorectal cancer (also known as colon or rectal cancer) is the second leading cause of cancer-related death among men and women in the U.S. Although it is easily treated if caught early, colorectal cancer causes nearly 50,000 deaths in the U.S. per year. Colorectal cancer also is one of the most commonly diagnosed cancers in the United

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What are the new recommended guidelines for early detection of colorectal cancer?

Based on an expert panel’s review of the historic and recent evidence, the following tests are acceptable options for the early detection of colorectal cancer and adenomatous polyps for asymptomatic, average risk adults aged 50 years and older: Tests That Detect Adenomatous Polyps and Cancer Flexible sigmoidoscopy (FSIG) every 5 years, or Colonoscopy (CSPY) every 10 years, or Double contrast barium enema (DCBE) every

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What is new and significant in these guidelines?

There are significant updates to the guidelines for colorectal cancer screening. Two new tests are now recommended as options for colorectal cancer screening. They are stool DNA (sDNA) and computerized tomographic (CT) colonography. For the first time, screening tests are grouped into categories based on performance characteristics: those that primarily detect cancer early and those that can also detect precancerous polyps. Tests that primarily

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What are the the major changes to these guidelines compared with previous reviews?

One significant change is the grouping of colorectal cancer screening methods into those that primarily identify cancer and those that both detect cancer and precancerous polyps, with a preference for those tests that can both detect cancer and prevent it by detecting premalignant polyps, which can then be removed. Another change is the panel’s recommendation that options for screening must be able to detect

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What topics did the current guideline review cover?

The latest guideline review reassessed the evidence for colorectal cancer screening tests that fall broadly into two categories: Tests that are more likely to detect both cancer and premalignant polyps Tests in this category are structural exams, including flexible sigmoidoscopy (FSIG), optical colonoscopy (CSPY), double contrast barium enema (DCBE), and computerized tomographic (CT) colonography. The higher likelihood of polyp detection with the use of

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What is the primary outcome of the review?

The expert panel believes that colon cancer prevention should be the primary goal of colorectal cancer screening. Screening tests that are designed to detect both early cancer and adenomatous polyps should be encouraged if resources are available and patients are willing to undergo an invasive test. These tests include flexible sigmoidoscopy, optical colonoscopy, air-contrast barium enema and CT colonography.

What are the early detection guidelines for those at increased risk for colorectal cancer?

In this update of the colorectal cancer screening guidelines, we have focused on screening in average risk adults and have not reviewed recent literature on colorectal cancer screening or surveillance among individuals at increased and high risk. Individuals at increased risk due to a history of adenomatous polyps, a personal history of curative-intent resection of colorectal cancer, or a family history of either colorectal

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If structural tests such as colonoscopy can prevent cancer, why not recommend only these tests?

These tests require bowel preparation and an office or hospital visit, and have various levels of risk to patients. They also have limitations, greater patient requirements for successful completion, and potential harms. The panel also recognized that some patients will not want to undergo an invasive test that requires bowel preparation, may prefer to have screening in the privacy of their home, or may

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What are the benefits and limitations of the fecal tests?

The primary advantage of these tests is that collection of fecal samples for blood or DNA testing can be performed at home, without bowel preparation. Fecal occult blood tests are also inexpensive on a per test basis when compared to other screening methods. However, these tests are less likely to lead to cancer prevention compared with the invasive tests; they must be repeated at

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Why is sDNA now recommended, and what are its strengths and limitations?

sDNA testing is a relatively new method of colorectal cancer screening. Cancer cells that contain altered DNA are continuously shed into the large bowel and passed in the feces, and this altered DNA can be isolated and identified through this screening test. In previous assessments, both the American Cancer Society and the U.S. Multi-Society Task Force concluded that data were insufficient to recommend screening

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