March 5, 2008 — The U.S. Multi-Society Task Force on Colorectal Cancer (a group that comprises representatives from the American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy) in conjunction with the American Cancer Society, and the American College of Radiology have released joint consensus guidelines (first-ever) for colorectal cancer screening. The list of recommended options now includes stool DNA (sDNA) and CT colonography (CTC), also known as virtual colonoscopy.
The expert panel felt very strongly that colon cancer prevention should be the primary goal of colorectal cancer screening. Thus, the guidelines state a preference for tests designed to detect both early cancer and adenomatous polyps as these tests have proven to provide a greater potential for cancer prevention through early polyp removal.
“This is the first time that guidelines from the American Cancer Society
express a strong preference for tests that can identify both polyps and cancer
and lead to cancer prevention,”
noted David A. Lieberman, M.D., on behalf of the U.S. Multi-Society Task Force
on Colorectal Cancer. “We feel strongly that this will help consumers
make decisions that can, quite literally,
save their lives.”
The guidelines, which represent the most current scientific evidence and expert opinion available, were published early online on the ACS website http://caonline.amcancersoc.org/. and will appear in the May/June issue of CA: A Cancer Journal for Clinicians. They will also be published later this year in the journals Gastroenterology and Radiology.
“Despite clear evidence that colorectal cancer screening saves lives
and the existence of several effective tests, screening rates have lagged,
costing thousands of lives every year,” said Otis W. Brawley, M.D., national
chief medical officer of the American Cancer Society. “Our hope is that
these new recommendations will help relieve some of the challenges health care
providers have had in promoting screening to their patients and lead to more
Americans preventing colon cancer by having polyps removed before they turn
into cancer.”
The panel recognized that some patients will not want to undergo an invasive
test that requires a bowel prep, may prefer to have screening in the privacy
of their home, or may not have access to the invasive tests due to lack of
coverage or local resources, so will opt for stool occult blood or DNA testing,
which can be performed at home, without bowel prep. But the
panel said providers and patients should understand that those tests are less
likely to prevent cancer compared with the invasive tests; they must be repeated
at regular intervals to be effective; and if the test is abnormal, an invasive
test (colonoscopy) will still be needed.
"The addition of these new technologies can potentially encourage many
more people to choose to be screened for colorectal cancer,” said Arl
Van Moore, M.D., FACR, chair of the American College of Radiology Board of
Chancellors. “This could result in early detection of the disease for
more patients, increasing the chance of successful treatment, and potentially
reduce colorectal
cancer deaths nationwide."
Based on a review of the historic and recent evidence, the following tests
were deemed acceptable options for the early detection of colorectal cancer
and adenomatous polyps for asymptomatic adults aged 50 years and older:
Other WIS Articles about Virtual Colonoscopy and Colorectal
Cancer
The Difference Between Virtual and Conventional
(Optical) Colonoscopy
FAQ’s About Virtual Colonoscopy
PET/CT Detects
Recurrent Colorectal Cancer
What Causes Colorectal
Cancer?
Can Colorectal Cancer
Be Prevented?
Stages of Colorectal
Cancer
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