Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults
Authors: Joseph B. Weiss, Nancy S. Cetel, Danielle E. Weiss
Journal: Annals of Internal Medicine (2020)

Letters7 April 2020Screening for Colorectal Cancer in Asymptomatic Average-Risk AdultsJoseph B. Weiss, MD, Nancy S. Cetel, MD, and Danielle E. Weiss, MDJoseph B. Weiss, MDUniversity of California, San Diego, San Diego, California (J.B.W., D.E.W.)Search for more papers by this author, Nancy S. Cetel, MDSpeaking of Health, Rancho Santa Fe, California (N.S.C.)Search for more papers by this author, and Danielle E. Weiss, MDUniversity of California, San Diego, San Diego, California (J.B.W., D.E.W.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0114 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read the ACP guidance statement on screening for CRC with interest (1). Developing guidelines for CRC screening in asymptomatic average-risk adults is challenging. The literature is inconsistent about screening technologies. The risks of screening colonoscopy increase with age, and this procedure is not recommended in patients older than 75 years. The incidence of CRC and polyps increases with age, but the risks of noninvasive and minimally invasive screening tests do not. Discontinuing safe, rapid, painless, and cost-effective screening with noninvasive fecal occult blood testing, FIT, or mt-sDNA testing or minimally invasive CTC or capsule colonoscopy at ...References1. Qaseem A, Crandall CJ, Mustafa RA, et al; Clinical Guidelines Committee of the American College of Physicians. Screening for colorectal cancer in asymptomatic average-risk adults: a guidance statement from the American College of Physicians. Ann Intern Med. 2019;171:643-54. [PMID: 31683290]. doi:10.7326/M19-0642 LinkGoogle Scholar2. Kluge MA, Williams JL, Wu CK, et al. Inadequate Boston Bowel Preparation Scale scores predict the risk of missed neoplasia on the next colonoscopy. Gastrointest Endosc. 2018;87:744-51. [PMID: 28648575] doi:10.1016/j.gie.2017.06.012 CrossrefMedlineGoogle Scholar3. Zhao S, Wang S, Pan P, et al. Magnitude, risk factors, and factors associated with adenoma miss rate of tandem colonoscopy: a systematic review and meta-analysis. Gastroenterology. 2019;156:1661-74. [PMID: 30738046] doi:10.1053/j.gastro.2019.01.260 CrossrefMedlineGoogle Scholar4. Mouchli MA, Ouk L, Scheitel MR, et al. Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer. World J Gastroenterol. 2018;24:905-16. [PMID: 29491684] doi:10.3748/wjg.v24.i8.905 CrossrefMedlineGoogle Scholar5. Patel SS, Kilgore ML. Cost effectiveness of colorectal cancer screening strategies. Cancer Control. 2015;22:248-58. [PMID: 26068773] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of California, San Diego, San Diego, California (J.B.W., D.E.W.)Speaking of Health, Rancho Santa Fe, California (N.S.C.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-0114. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening for Colorectal Cancer in Asymptomatic Average-Risk Adults: A Guidance Statement From the American College of Physicians Amir Qaseem , Carolyn J. Crandall , Reem A. Mustafa , Lauri A. Hicks , Timothy J. Wilt , and Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults Timothy J. Wilt , Carolyn J. Crandall , Lauri A. Hicks , Reem A. Mustafa , and Amir Qaseem Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults Thomas F. Imperiale , Steven H. Itzkowitz , David F. Ransohoff , and Philip Lavin Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults David H. Kim Metrics Cited byAttribution of Colonoscopy Risk Does Not FIT! 7 April 2020Volume 172, Issue 7Page: 508KeywordsCancer screeningColonoscopyHematologic testsIntubationLife expectancyMorbidityMortalityQuality adjusted life yearsScreening guidelinesSedation ePublished: 7 April 2020 Issue Published: 7 April 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...