Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults
Authors: Thomas F. Imperiale, Steven H. Itzkowitz, David F. Ransohoff, Philip Lavin
Journal: Annals of Internal Medicine (2020)

Letters7 April 2020Screening for Colorectal Cancer in Asymptomatic Average-Risk AdultsThomas F. Imperiale, MD, Steven H. Itzkowitz, MD, David F. Ransohoff, MD, and Philip Lavin, PhDThomas F. Imperiale, MDIndiana University Medical Center, Indianapolis, Indiana (T.F.I.)Search for more papers by this author, Steven H. Itzkowitz, MDIcahn School of Medicine at Mount Sinai, New York, New York (S.H.I.)Search for more papers by this author, David F. Ransohoff, MDUniversity of North Carolina, Chapel Hill, North Carolina (D.F.R.)Search for more papers by this author, and Philip Lavin, PhDBoston Biostatistical Research Foundation, Framingham, Massachusetts (P.L.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0113 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The ACP guidance statement on CRC screening (1) is inconsistent with the guidelines of other professional organizations (2–4). Because this guidance statement only recommends tests supported by evidence from RCTs, the authors declined to recommend multitarget stool DNA (mt-sDNA) testing (1). However, they do recommend fecal immunochemical testing (FIT) despite the absence of evidence from RCTs and lack of consistency in hemoglobin thresholds among the many available FITs. Previous medical society guidelines initially included FIT because of its superior diagnostic accuracy over guaiac-based occult blood testing. Shouldn't this allowance also apply to mt-sDNA testing, which includes FIT ...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. Bibbins-Domingo K, Grossman DC, Curry SJ, et al; US Preventive Services Task Force. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA. 2016;315:2564-75. [PMID: 27304597] doi:10.1001/jama.2016.5989 CrossrefMedlineGoogle Scholar3. Rex DK, Boland CR, Dominitz JA, et al. Colorectal cancer screening: recommendations for physicians and patients from the U.S. Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol. 2017;112:1016-30. [PMID: 28555630] doi:10.1038/ajg.2017.174 CrossrefMedlineGoogle Scholar4. Wolf AMD, Fontham ETH, Church TR, et al. Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA Cancer J Clin. 2018;68:250-81. [PMID: 29846947] doi:10.3322/caac.21457 CrossrefMedlineGoogle Scholar5. Imperiale TF, Ransohoff DF, Itzkowitz SH, et al. Multitarget stool DNA testing for colorectal-cancer screening. N Engl J Med. 2014;370:1287-97. [PMID: 24645800] doi:10.1056/NEJMoa1311194 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Indiana University Medical Center, Indianapolis, Indiana (T.F.I.)Icahn School of Medicine at Mount Sinai, New York, New York (S.H.I.)University of North Carolina, Chapel Hill, North Carolina (D.F.R.)Boston Biostatistical Research Foundation, Framingham, Massachusetts (P.L.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-0113. 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 Joseph B. Weiss , Nancy S. Cetel , and Danielle E. Weiss 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 David H. Kim Metrics 7 April 2020Volume 172, Issue 7Page: 507-508KeywordsCancer screeningColonoscopyDNADisclosureHematologic testsHemoglobinMortalityScreening guidelinesSpecificity ePublished: 7 April 2020 Issue Published: 7 April 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...