ITEMS IN AFP WITH KEYWORD:
Although much has been written about the need to encourage colonoscopy in underscreened populations, overscreening for colorectal cancer is now recognized as a problem that can lead to harm.
Fecal DNA testing is more sensitive but less specific than fecal immunochemical testing (FIT), and as a result, has a higher false-positive rate. It is also more expensive than other noninvasive alternatives such as FIT. We do not know which test will be better at reducing mortality.
Immunochemical FOBTs, such as OC-Micro, OC-Sensor, or OC-Light, are moderately sensitive (73% to 89%) and highly specific (92% to 95%) for identifying colorectal cancer. In comparison, Hemoccult Sensa has a lower sensitivity (64% to 80%) and specificity (87% to 90%). Immunochemical FOBTs also have the advantage of requiring only one sample.
Compared with minimal follow-up after surgery for colorectal cancer, intensive follow-up with regular computed tomography (CT), carcinoembryonic antigen (CEA) testing, or both results in more patients undergoing repeat surgery but no reduction in overall mortality or disease-specific mortality.
There appears to be no advantage to obtaining FIT more often than every three years.
Dec 15, 2012 Issue
ACP Releases Best Practice Advice on Colorectal Cancer Screening [Practice Guidelines]
The American College of Physicians (ACP) recently reviewed guidelines on colorectal cancer screening available from the American Cancer Society/U.S. Multi-Society Task Force on Colorectal Cancer/American College of Radiology, Institute for Clinical Systems Improvement, U.S. Preventive Services Task ...
Apr 15, 2010 Issue
Screening for Colorectal Cancer: Recommendation Statement [U.S. Preventive Services Task Force]
The U.S. Preventive Services Task Force (USPSTF) recommends screening for colorectal cancer in adults using fecal occult blood test (FOBT), sigmoidoscopy, or colonoscopy, beginning at 50 years of age and continuing until 75 years of age. The risks and benefits of these screening methods vary.
Case study: N.P., a 51-year-old man, comes to your office because one of his friends was recently diagnosed with colorectal cancer. He is wondering whether he should be screened too.
The American College of Gastroenterology (ACG) updated its recommendations on screening for colorectal cancer in 2008, and continues to support colonoscopy in average-risk patients every 10 years based on the evidence of effectiveness, cost-effectiveness, and patient acceptance.
Feb 15, 2009 Issue
Routine Aspirin or Nonsteroidal Anti-inflammatory Drugs for the Primary Prevention of Colorectal Cancer [Putting Prevention into Practice]
Case study: B.L., a 37-year-old Asian man, comes to your office for a physical examination. He mentions that he started taking a daily aspirin because he heard that it would reduce his risk of heart attack and colorectal cancer.