The guidelines were published by the American Cancer Society and a consortium of experts representing the American College of Gastroenterology, American Gastroenterological Association, American Society of Colon and Rectal Surgeons, American Society for Gastrointestinal Endoscopy, and the American Gastrointestinal Endoscopic Surgeons. This article continues that discussion by presenting expected results from an initial round of screening a typical population of 1,000 patients ages 40 to 80.
Emphasis is placed on when to alter or stop usual screening recommendations.
Colorectal cancer screening will reduce cancer mortality when correct tests are ordered, when skilled practitioners perform the screening exams, and when surveillance continues for as long as risk of CRC mortality is significant. This article concerns the third question. Screening is applicable only to asymptomatic people and may need to be initiated earlier than usual when a patient has a family history of colorectal cancer. Four genetic mutations now are recognized to confer increased CRC risk. Gene testing is commercially available and should be offered to appropriate families following pedigree analysis and counseling.