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Guidance for CRC Screening

Guidance for CRC Screening

Colorectal cancer (CRC) has been the subject of screening guidelines from multiple organizations, creating some confusion among caregivers over which has the highest-quality, evidence-based recommendations. Rather than developing an additional guideline on the topic, the American College of Physicians recently decided that it would be more valuable to provide information to clinicians based on a rigorous review of currently available guidelines. Making Sense of CRC Literature My colleagues and I developed this guidance statement using current recommendations from a joint guideline from the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology, as well as individual guidelines from the Institute for Clinical Systems Improvement, the U.S. Preventive Services Task Force, and the American College of Radiology. Based on our evaluations, we developed four guidance statements for CRC screening: 1. Clinicians should perform individualized assessment of risk for CRC in all adults. 2. Clinicians should screen for CRC in average-risk adults starting at age 50 and in high-risk adults starting at age 40 or 10 years younger than the age at which the youngest affected relative was diagnosed with CRC. 3. Clinicians should use a stool-based test, flexible sigmoidoscopy, or optical colonoscopy as a screening test in average-risk patients. Optical colonoscopy should be used in high-risk patients. Clinicians should select the test based on the benefits and harms of the test, availability of the test, and patient preferences. 4. Clinicians should stop screening for CRC in adults older than age 75 or in adults with a life expectancy of less than 10 years. The evidence reviewed in our guidance statement showed that...
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