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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