Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society
Andrew M.D. Wolf,Elizabeth T. H. Fontham,Timothy R. Church,Christopher R. Flowers,Carmen Guerra,Samuel J. LaMonte,Ruth Etzioni,Matthew T. McKenna,Kevin C. Oeffinger,Ya Chen Tina Shih,Louise C. Walter,Kimberly S. Andrews,Otis W. Brawley,Durado Brooks,Stacey A. Fedewa,Deana Manassaram-Baptiste,Rebecca L. Siegel,Richard C. Wender,Robert A. Smith +18 more
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TLDR
This guideline update used an existing systematic evidence review of the CRC screening literature and microsimulation modeling analyses, including a new evaluation of the age to begin screening by race and sex and additional modeling that incorporates changes in US CRC incidence.Abstract:
In the United States, colorectal cancer (CRC) is the fourth most common cancer diagnosed among adults and the second leading cause of death from cancer. For this guideline update, the American Cancer Society (ACS) used an existing systematic evidence review of the CRC screening literature and microsimulation modeling analyses, including a new evaluation of the age to begin screening by race and sex and additional modeling that incorporates changes in US CRC incidence. Screening with any one of multiple options is associated with a significant reduction in CRC incidence through the detection and removal of adenomatous polyps and other precancerous lesions and with a reduction in mortality through incidence reduction and early detection of CRC. Results from modeling analyses identified efficient and model-recommendable strategies that started screening at age 45 years. The ACS Guideline Development Group applied the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria in developing and rating the recommendations. The ACS recommends that adults aged 45 years and older with an average risk of CRC undergo regular screening with either a high-sensitivity stool-based test or a structural (visual) examination, depending on patient preference and test availability. As a part of the screening process, all positive results on noncolonoscopy screening tests should be followed up with timely colonoscopy. The recommendation to begin screening at age 45 years is a qualified recommendation. The recommendation for regular screening in adults aged 50 years and older is a strong recommendation. The ACS recommends (qualified recommendations) that: 1) average-risk adults in good health with a life expectancy of more than 10 years continue CRC screening through the age of 75 years; 2) clinicians individualize CRC screening decisions for individuals aged 76 through 85 years based on patient preferences, life expectancy, health status, and prior screening history; and 3) clinicians discourage individuals older than 85 years from continuing CRC screening. The options for CRC screening are: fecal immunochemical test annually; high-sensitivity, guaiac-based fecal occult blood test annually; multitarget stool DNA test every 3 years; colonoscopy every 10 years; computed tomography colonography every 5 years; and flexible sigmoidoscopy every 5 years. CA Cancer J Clin 2018;68:250-281. © 2018 American Cancer Society.read more
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Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries.
Hyuna Sung,Jacques Ferlay,Rebecca L. Siegel,Mathieu Laversanne,Isabelle Soerjomataram,Ahmedin Jemal,Freddie Bray +6 more
TL;DR: The GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer (IARC) as mentioned in this paper show that female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung cancer, colorectal (11 4.4%), liver (8.3%), stomach (7.7%) and female breast (6.9%), and cervical cancer (5.6%) cancers.
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Colorectal cancer statistics, 2020.
Rebecca L. Siegel,Kimberly D. Miller,Ann Goding Sauer,Stacey A. Fedewa,Lynn F. Butterly,Lynn F. Butterly,Joseph C. Anderson,Joseph C. Anderson,Andrea Cercek,Robert A. Smith,Ahmedin Jemal +10 more
TL;DR: Progress against CRC can be accelerated by increasing access to guideline‐recommended screening and high‐quality treatment, particularly among Alaska Natives, and elucidating causes for rising incidence in young and middle‐aged adults.
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Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement
Kirsten Bibbins-Domingo,David C. Grossman,Susan J. Curry,Karina W. Davidson,John W. Epling,Francisco A.R. Garcia,Matthew W. Gillman,Diane M. Harper,Alex R. Kemper,Alex H. Krist,Ann E. Kurth,C. Seth Landefeld,Carol M. Mangione,Douglas K Owens,Douglas K Owens,William R. Phillips,Maureen G. Phipps,Michael Pignone,Albert L. Siu,Albert L. Siu +19 more
TL;DR: It is concluded with high certainty that screening for colorectal cancer in average-risk, asymptomatic adults aged 50 to 75 years is of substantial net benefit.
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Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies
NaNa Keum,Edward Giovannucci +1 more
TL;DR: With increasing incidence of CRC at younger ages, there is an urgent need to better identify high-risk individuals younger than 50 years, the age when screening typically starts, and aspirin probably confers chemopreventive benefit against CRC.
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Annual Report to the Nation on the Status of Cancer, part I: National cancer statistics
Kathleen A. Cronin,Andrew J. Lake,Susan Scott,Recinda L. Sherman,Anne-Michelle Noone,Nadia Howlader,S. Jane Henley,Robert N. Anderson,Albert U. Firth,Jiemin Ma,Betsy A. Kohler,Ahmedin Jemal +11 more
TL;DR: The American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate to provide annual updates on cancer occurrence and trends in the United States.
References
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Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer
Douglas K. Rex,C. Richard Boland,Jason A. Dominitz,Francis M. Giardiello,David A. Johnson,Tonya Kaltenbach,Theodore R. Levin,David Lieberman,Douglas J. Robertson +8 more
TL;DR: This document updates the colorectal cancer screening recommendations of the U.S. Multi-Society Task Force of Colorectals and suggests that the Septin9 serum assay (Epigenomics, Seattle, Wash) not be used for screening.
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Complications of colonoscopy in an integrated health care delivery system.
Theodore R. Levin,Wei Zhao,Carol Conell,Laura C. Seeff,Diane L. Manninen,Jean A. Shapiro,Jane Schulman +6 more
TL;DR: The authors searched electronic health records at Kaiser-Permanente of Northern California for patients who died or who had complications due to colonoscopy within 30 days of the procedure, relying on the automated data of Kaiser Permanente, Northern California, an integrated health care delivery system to evaluate practice patterns.
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Adherence to Colorectal Cancer Screening: A Randomized Clinical Trial of Competing Strategies
John M. Inadomi,Sandeep Vijan,Nancy K. Janz,Angela Fagerlin,Jennifer P. Thomas,Yunghui V. Lin,Roxana Munoz,Chim Lau,Ma Somsouk,Najwa El-Nachef,Rodney A. Hayward +10 more
TL;DR: The common practice of universally recommending colonoscopy may reduce adherence to CRC screening, especially among racial/ethnic minorities, and results suggest that patient preferences should be considered when making CRC screening recommendations.
Journal ArticleDOI
GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines
Pablo Alonso-Coello,Pablo Alonso-Coello,Andrew D Oxman,Jenny Moberg,Romina Brignardello-Petersen,Elie A. Akl,Marina Davoli,Shaun Treweek,Reem A. Mustafa,Per Olav Vandvik,Joerg J Meerpohl,Gordon H. Guyatt,Holger J. Schünemann +12 more
TL;DR: Clinicians regularly face situations with two or more alternative actions, each of which often has different advantages and disadvantages, including differences in effectiveness, adverse effects, costs and other factors.
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Reduction in colorectal cancer mortality by fecal occult blood screening in a French controlled study.
Jean Faivre,Vincent Dancourt,Catherine Lejeune,Mohamed A. Tazi,Joseph Lamour,Dominique Gerard,Frederic Dassonville,Claire Bonithon-Kopp +7 more
TL;DR: It is suggested that biennial screening by FOBTs can reduce CRC mortality regardless of the quality of the health system and support attempts to introduce large-scale screening programs into the general population.
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