Colorectal Cancer Screening Clinical Practice Guidelines

2006 ◽  
Vol 4 (4) ◽  
pp. 384 ◽  
Author(s):  
_ _

Colorectal cancer is the third most frequently diagnosed cancer in men and women in the United States. An estimated 104,950 new cases of colon cancer and 40,340 new cases of rectal cancer will occur in the United States in 2005. During the same year, an estimated 56,290 people will die from colon and rectal cancer. Because patients with localized colon cancer have a 90% 5-year survival rate, screening is a critical and particularly effective procedure for colorectal cancer prevention. Screening options include colonoscopy; combined fecal occult blood test (FOBT) and sigmoidoscopy; sigmoidoscopy alone; or double-contrast barium enema. For the most recent version of the guidelines, please visit NCCN.org

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 288-288
Author(s):  
Thi Khuc ◽  
Christian Jackson

288 Background: Colorectal cancer (CRC) is the second most common cause of cancer deaths in the United States and expected to cause 51,020 deaths in 2019. Early detection with yearly fecal occult blood test (FOBT) has been proven to decrease CRC mortality. A 30-day delay from positive FOBT to colonoscopy is associated with increased risk of CRC. The Veterans Affairs Health System (VAHS) treats approximately 11% of CRCs in the United States. The effects of an aging population, physician shortage, and increased military personnel entering the VAHS may increase demands on VAHS resources. The primary aim of this study was to determine risk factors that caused delay to colonoscopy. Methods: We retrospectively reviewed records of 600 patients referred for colonoscopy from January 1999 to January 2009, who were subsequently diagnosed with CRC. Patients with a prior CRC diagnosis were excluded. The final study cohort consisted of 530 patients. We analyzed the relationship between 10 variables and delay in time from initial consultation to colonoscopy. Variables consisted of age, sex, race, ethnicity, CRC location, marital status, history of mental health diagnosis, tobacco use, substance abuse, Charlson/Deyo (C/D) score and season of referral for colonoscopy. A delay in time was defined as 30 days or greater. Logistic regression analysis adjusted for age, race, CRC location and C/D score. Results: A total of 87.17% of patients experienced a delay in time from initial consultation to colonoscopy. When analyzed with a predictive variable of delay to colonoscopy, C/D score of ≥ 2 versus 0, was associated with higher odds of delay in time to colonoscopy (OR = 2.18, p = 0.02). African American race and Hispanic ethnicity was associated with a higher odds of delay in time to colonoscopy, but was not statistically significant (OR = 1.47, p = 0.47, OR = 1.37, p = 0.48). Conclusions: Patients with a C/D score ≥ 2 were 218% more likely to have delay in time from initial consult to colonoscopy, resulting in a delayed CRC diagnosis. C/D score may be used to determine which patients should have more frequent reminders to schedule their colonoscopy to prevent delays in care. Randomized and prospective studies will need to be performed.


1991 ◽  
Vol 161 (1) ◽  
pp. 101-106 ◽  
Author(s):  
Jon B. Morris ◽  
Thomas A. Stellato ◽  
Barbara B. Guy ◽  
Nahida H. Gordon ◽  
Nathan A. Berger

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15079-e15079
Author(s):  
Joy A Lee ◽  
Xia Bi ◽  
Connie Y Huang ◽  
Walter Coyle

e15079 Background: With increasing life expectancy, the incidence of colorectal cancer increases. Currently, there are few studies on cancer outcomes of outpatient colonoscopy in patients older than 85 years of age. Methods: The database at Scripps was queried for all outpatient colonoscopies performed under moderate sedation between April 1, 2012 to March 31, 2017 on patients aged 85 years and older. Patient demographics, indication for procedure, and endoscopic findings were obtained. Variables including location and stage of tumor, subsequent treatments, and overall mortality were analyzed. Results: 322 outpatient colonoscopies were reviewed. Median age was 86 years. 53% were females. Screening colonoscopies accounted for 2.1% of procedures. 40 (12.4%) colon cancers were detected. 38 (95%) were adenocarcinomas and 2 (5%) were neuroendocrine tumors. 26 (65%) were right sided colon cancers. Among those diagnosed with cancer, anemia was the most common indication followed by positive fecal occult blood test (FOBT). 20 (50%) of these patients had a FOBT within the past year. Of those FOBTs, 18 (90%) were positive. Median age of patients with colon cancer was 88 years. 70% were females. 12 (30%) patients had never had a colonoscopy. 19 (47.5%) were diagnosed at an advanced stage (stage III or IV). 32 (80%) pursued surgery, 10 (25%) received chemotherapy, and 5 (12.5%) received radiation. 3 (7.5%) patients received supportive care only. 1-year mortality was 22.5% and 3-year mortality was 40% from the time of diagnosis. Conclusions: To date, this is the first study in the United States that examines cancer outcomes in an elderly population undergoing an outpatient colonoscopy. Overall, patients over the age of 85 with colorectal cancer have good outcomes that are comparable to that of the general population and colonoscopies should be considered for appropriate candidates.


2021 ◽  
Vol 7 (2) ◽  
pp. 097-103
Author(s):  
Ashan T Hatharasinghe ◽  
Ike R Ogbu ◽  
Abdul G Gheriani ◽  
George A Trad ◽  
Andre E Manov

Colorectal cancer (CRC) remains a frequently addressed topic in primary care. Recent studies have been published detailing modifiable risk factors for CRC, as well as preventative measures. Providers must be up to date on screening recommendations and modalities. Colonoscopy is the preferred method of screening for CRC, and the screening recommendations in the United States were recently updated in 2020. It is also common for the practitioner to encounter patients who refuse colonoscopy but are willing to undergo alternative methods of testing. The COVID pandemic has also placed a burden on hospital resources, and colonoscopy may not be logistically feasible in some healthcare settings. Therefore, awareness of the guidelines for the various alternative modalities, along with their respective guidelines for frequency of screening is critical. This article provides a brief review of the risk factors associated with colon cancer, the screening modalities (including colonoscopy, sigmoidoscopy, CT colonography, fecal immunohistochemical testing (FIT), guaiac-based fecal occult blood testing (gFOBT), multi target stool DNA testing (MTs-DNA), and others) and the most recent screening recommendations for the general population.


1996 ◽  
Vol 3 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Bernard Levin

Colorectal cancer is a major cause of morbidity and mortality in the United States. Early detection of the disease at an asymptomatic stage by screening holds promise for lowering the incidence of colorectal cancer deaths, yet compliance with screening guidelines is poor. Evidence in support of the use of screening techniques for colorectal cancer is accumulating, however, and screening for this disease with fecal occult blood tests and flexible sigmoidoscopy can increase the likelihood of early detection, can decrease mortality and morbidity, and can be cost effective.


2007 ◽  
Vol 5 (9) ◽  
pp. 940
Author(s):  
_ _

In 2007, an estimated 41,420 new cases of rectal cancer will occur in the United States (23,840 cases in men; 17,580 cases in women). The guidelines for rectal cancer overlap considerably with those for colon cancer, and the panel unanimously endorses patient participation in a clinical trial over standard or accepted therapy in both. This is especially true for cases of advanced disease and for patients with locally aggressive colorectal cancer who are receiving combined modality treatment. The latest updates of the NCCN Anal Carcinoma Clinical Practice Guidelines in Oncology are available online at www.nccn.org. For the most recent version of the guidelines, please visit NCCN.org


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