ACP Issues CRC Screening “Guidance Statement”; Declines to Endorse Either FIT-Fecal DNA or CT Colonography
Douglas K. Rex, MD, FASGE reviewing Qaseem A, et al. Ann Intern Med 2019 Nov 5.
The American College of Physicians (ACP) has issued a guidance statement on colorectal cancer screening in average-risk adults; the guidance statement is based on a review of other published guidelines and not on its own independent review of original data. The ACP rated the quality of the U.S. Preventive Services Task Force and Canadian Task Force on Preventive Health Care (CTFPHC) guidelines the highest (The CTFPHC declined to recommend screening colonoscopy.).
Key recommendations include:
- Screening average-risk adults between ages 50 to 75 is endorsed.
- Screening should be stopped in average-risk adults older than 75 years or if life expectancy is 10 years or less.
- Suggested tests include:
- The fecal immunochemical test (FIT) or high-sensitivity guaiac-based fecal occult blood test every 2 years.
- Colonoscopy every 10 years.
- Flexible sigmoidoscopy every 10 years plus FIT every 2 years.
- Fecal DNA and CT colonography were evaluated and rejected as recommended screening options.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
Douglas K. Rex, MD, FASGE
Qaseem A, Crandall CJ, Mustafa RA, et al. Screening for colorectal cancer in asymptomatic average-risk adults: a guidance statement from the American College of Physicians. Ann Intern Med 2019;171:643-654. (https://doi.org/10.7326/M19-0642)