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Oct 15, 2016 Issue
Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer [Putting Prevention into Practice]
S.L. is a 55-year-old man who presents to your office for a routine refill of his antihypertension medication. He also takes a statin and an antidepressant. Although he smokes, his blood pressure and cholesterol are well controlled. His history and physical examination are unremarkable.
Oct 15, 2016 Issue
Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: Recommendation Statement [U.S. Preventive Services Task Force]
The USPSTF recommends initiating low-dose aspirin use for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years, ...
Colon cancer screening should begin at 50 years of age in average-risk persons. Find out the recommendations for patients with risk factors, and surveillance guidelines based on initial screening results.
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.