MONDAY, Nov. 4, 2019 (HealthDay News) — Average-risk adults between the ages of 50 and 75 years should be screened for colorectal cancer, with the screening test selected based on discussion with patients, according to a guidance statement from the American College of Physicians published online Nov. 5 in the Annals of Internal Medicine.

Amir Qaseem, M.D., Ph.D., from the American College of Physicians in Philadelphia, and colleagues derived guidance statements from a critical appraisal of guidelines and the evidence presented in these guidelines on screening for colorectal cancer in average-risk adults.

The authors developed three guidance statements for all clinicians. In average-risk adults between the ages of 50 and 75 years, clinicians should screen for colorectal cancer. Based on discussion of the benefits, harms, costs, availability, frequency, and patient preferences, clinicians should select the colorectal cancer screening test with the patient. The screening tests suggested are fecal immunochemical testing or high-sensitivity guaiac-based fecal occult blood testing every two years; colonoscopy every 10 years; or flexible sigmoidoscopy every 10 years and fecal immunochemical testing every two years. In average-risk adults older than 75 years or in adults with a life expectancy of 10 years or less, clinicians should discontinue screening for colorectal cancer.

“A challenge to reconciling the guidelines is that several important questions have not been, and likely will not be, addressed directly in trials because of the trial size that would be required to answer them,” writes the author of an accompanying editorial.

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