3 controversial trends in gastroenterology

Here are three controversial trends ASC industry leaders should know:

1. The updated recommended age for cancer screenings

In August, the American College of Physicians updated its guidance for colorectal screenings in asymptomatic, average-risk patients from age 45 to 50. 

Many leaders are skeptical of this decision considering recent research from the American Cancer Society that shows adults ages 40 to 54 are seeing the steepest increase in colorectal cancer rates. 

"The move to increase the recommended age for colorectal cancer screenings is a bit surprising to me given the rising rates of colorectal cancer we've seen in younger patients, and the U.S. Preventive Services Task Force's recommendation that colorectal cancer screening begin at age 45 for average-risk individuals," Shrujal Baxi, MD, chief medical officer at Iterative Health, told Becker's

2. Prior authorizations

Prior authorizations are one of the biggest issues for gastroenterologists. 

"No matter what kind of physician you are, prior authorizations are something that physicians are concerned about because of the amount of extra time required to take care of those phone calls," Benjamin Levy III, MD, a gastroenterologist at the University of Chicago Medicine, told Becker's. "Physicians who are well trained are making very good decisions clinically about workup and management of their patients. So instead of taking care of another patient that same day, we're ending up spending time with the prior authorization process."

Major gastroenterology associations have been working to change prior authorization requirements. In August, the American Gastroenterological Association wrote a letter to UnitedHealthcare asking the payer to withdraw its advanced notification program for gastroenterological care. The insurer has since offered no response, according to an Oct. 11 statement from the AGA. 

3. Artificial intelligence

Artificial intelligence is becoming increasingly common in gastroenterology, including devices that can use previous images to detect polyps that might have otherwise been missed. 

But some ASC leaders, including Shyam Thakkar, MD, director of advanced therapeutic endoscopy at Morgantown-based West Virginia University School of Medicine, are pushing physicians to be wary of the limitations. 

"Despite [a colonoscopy's] obvious advantages, there are still limitations to it," he said. "Small polyps or even significantly-sized polyps can be missed at the time of the colonoscopy. AI helps us in the sense that while the endoscopist is performing an exam, this miss rate can be reduced because it actually helps us identify where these polyps might be."

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