(ChemotherapyAdvisor) – The American College of Physicians (ACP) has issued a new guidance statement and patient summary to increase understanding of the benefits and harms of colorectal cancer screening. Published in the March 6 issue of Annals of Internal Medicine, the ACP notes that colorectal cancer is the second leading cause of cancer-related deaths for men and women in the United States, yet only about 60% of those ages 50 years and older are screened annually.

The ACP developed these clinical guidelines based on an evaluation of a joint guideline developed by the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology and individual guidelines developed by the Institute for Clinical Systems Improvement, the U.S. Preventive Services Task Force, and the American College of Radiology.

The full text of the guidelines follows:

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Guidance Statement 1: ACP recommends that clinicians perform individualized assessment of risk for colorectal cancer in all adults.

Guidance Statement 2: ACP recommends that clinicians screen for colorectal cancer in average-risk adults starting at the age of 50 years and in high-risk adults starting at the age of 40 years, or 10 years younger than the age at which the youngest affected relative was diagnosed with colorectal cancer.

Guidance Statement 3: ACP recommends using a stool-based test, flexible sigmoidoscopy, or optical colonoscopy as a screening test in patients who are at average risk. ACP recommends using optical colonoscopy as a screening test in patients who are at high risk. Clinicians should select the test based on the benefits and harms of the screening test, availability of the screening test, and patient preferences.

Guidance Statement 4: ACP recommends that clinicians stop screening for colorectal cancer in adults over the age of 75 years or in adults with a life expectancy of less than ten years.


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