Colorectal Cancer Screening.

2020 Colorectal Cancer Screening Recommendations, per the American College of Physicians consensus statement

Why is this so important? Colorectal cancer (CRC) is the second leading cause of cancer death in the US. There is a 65% overall five-year survival. Removal of adenomas can prevent cancer.

What does screening mean? Screening are baseline tests. This means that the CRC patient is asymptomatic (no rectal bleeding, no change in bowel habits, and no abdominal pain) AND has no increased risk (no history of polyps or no family history of colon cancer). These consensus statements are NOT generalized to people at elevated CRC risk.

Who to screen? The BMJ/MAGIC Group recommends calculating a patient’s CRC risk. https://qcancer.org/15yr/colorectal/ If the 15 year risk of CRC is less than 3% no screening for CRC is recommended. Routine recommendations are to perform CRC screening to average-risk asymptomatic adults from aged 50 to 79 with at least 15 years of life expectancy.

Methods of screening? Colonoscopy reduces incidence of premalignant adenomas by 34% because the GI doctor can remove polyps during a colonoscopy. Patients who have noninvasive tests like FIT tests of guaiac fecal occult blood testing cannot remove polyps with the testing.

Guidelines/Timelines for screening for CRC by method…

-Colonoscopy. Every 10 years. Benefits: may be fully paid by your insurance as it is a considered a screening test. Physician can remove polyps at the time of scope. Drawbacks: need to do a bowel prep.

-FIT. Every 2 years. Benefits: no bowel prep needed. Submit a single stool sample to the lab. No dietary restrictions. Drawbacks: If positive, you need a colonoscopy. Insurance, then, may code your colonoscopy as a diagnostic test and you may have a big insurance bill.

When to stop screening? CRC screening is not recommended after 75 years of age or when life expectancy is less than 10 years.

About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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