Controversies in Colorectal Cancer Screening
Authors: Christine Laine, Amir Qaseem, Darilyn V. Moyer
Journal: Annals of Internal Medicine (2023)

Special Articles12 December 2023Controversies in Colorectal Cancer ScreeningChristine Laine, MD, MPH, Amir Qaseem, MD, PhD, MHA, Darilyn V. Moyer, MDChristine Laine, MD, MPHEditor in Chief, Annals of Internal Medicine Search for more papers by this author, Amir Qaseem, MD, PhD, MHASenior Vice President, Clinical Policy, and Chief Science Officer, American College of PhysiciansSearch for more papers by this author, Darilyn V. Moyer, MDExecutive Vice President and Chief Executive Officer, American College of PhysiciansSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-3086 Eligible for CME Point-of-CareCME/MOC SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Colorectal cancer is a leading cause of cancer-related morbidity and mortality worldwide (1). Screening not only identifies this cancer at early, more easily treatable stages but also identifies precancerous lesions that can be removed so that cancer does not occur.Yet, there is controversy among experts about how best to screen and whom to screen for colorectal cancer (2). Consequently, screening recommendations vary considerably around the globe and even among organizations within the United States. The differing recommendations are a source of confusion for clinicians and patients. This controversy surfaced in force in August 2023 when the American College of ...References1. World Health Organization. Fact Sheet: Cancer. 3 February 2022. Accessed at www.who.int/news-room/fact-sheets/detail/cancer?gclid=CjwKCAiA98WrBhAYEiwA2WvhOj0cV__KSKjz4TUqKDCcGeS6WF7Q_CQPeIRMu91FcHuCX3GYA6KrqhoClNcQAvD_BwE on 6 December 2023. Google Scholar2. Burns RB, Mangione CM, Weinberg DS, et al. How would you screen this patient for colorectal cancer? Grand rounds discussion from Beth Israel Deaconess Medical Center. Ann Intern Med. 2022;175:1452-1461. [PMID: 36215708] doi:10.7326/M22-1961 LinkGoogle Scholar3. Qaseem A, Harrod CS, Crandall CJ, 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 (Version 2). Ann Intern Med. 2023;176:1092-1100. [PMID: 37523709] doi:10.7326/M23-0779 LinkGoogle Scholar4. U.S. Preventive Services Task Force. Final Recommendation Statement. Colorectal Cancer: Screening. 18 May 2021. Accessed at www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening on 6 December 2023. Google Scholar5. 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;68:250-281. [PMID: 29846947] doi:10.3322/caac.21457 CrossrefMedlineGoogle Scholar6. Shaukat A, Kahi CJ, Burke CA, et al. ACG clinical guidelines: colorectal cancer screening 2021. Am J Gastroenterol. 2021;116:458-479. [PMID: 33657038] doi:10.14309/ajg.0000000000001122 CrossrefMedlineGoogle Scholar7. Patel SG, May FP, Anderson JC, et al. Updates on age to start and stop colorectal cancer screening: recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2022;162:285-299. [PMID: 34794816] doi:10.1053/j.gastro.2021.10.007 CrossrefMedlineGoogle Scholar8. Bretthauer M, Løberg M, Wieszczy P, et al; NordICC Study Group. Effect of colonoscopy screening on risks of colorectal cancer and related death. N Engl J Med. 2022;387:1547-1556. [PMID: 36214590] doi:10.1056/NEJMoa2208375 CrossrefMedlineGoogle Scholar9. Montminy EM, Zhou M, Maniscalco L, et al. Contributions of adenocarcinoma and carcinoid tumors to early-onset colorectal cancer incidence rates in the United States. Ann Intern Med. 2021;174:157-166. [PMID: 33315473] doi:10.7326/M20-0068 LinkGoogle Scholar10. Knudsen AB, Rutter CM, Peterse EFP, et al. Colorectal Cancer Screening: An Updated Decision Analysis for the U.S. Preventive Services Task Force: Report No. 20-05271-EF-2. Rockville: Agency for Healthcare Research and Quality. May 2021. [PMID: 34097370] MedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Christine Laine, MD, MPH; Amir Qaseem, MD, PhD, MHA; Darilyn V. Moyer, MDAffiliations: Editor in Chief, Annals of Internal Medicine Senior Vice President, Clinical Policy, and Chief Science Officer, American College of PhysiciansExecutive Vice President and Chief Executive Officer, American College of PhysiciansDisclosures: All relevant financial relationships have been mitigated. Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-3086.Editors' Disclosures: The editors have no relevant financial relationships to disclose. Individual forms may be viewed at www.annals.org/editorsdisclosures.Corresponding Author: Christine Laine, MD, MPH, Editor in Chief, Annals of Internal Medicine, 190 N. Independence Mall West, Philadelphia, PA 19106; e-mail, claine@acponline.org.This article was published at Annals.org on 12 December 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Current IssueJanuary 2024Volume 177, Issue 1Page: 83-84KeywordsColorectal cancerColorectal cancer screening ePublished: 12 December 2023 Issue Published: January 2024 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...