A new white paper from the American Gastroenterological Association calls for better risk assessment, more noninvasive testing options and targeted colonoscopy referrals to reduce colorectal cancer fatalities.
The white paper is based on analysis by 60 gastroenterology and research experts as to how CRC screening could reach its full potential.
Under current standards, about 67 percent of eligible Americans are screened for CRC. Physicians typically recommend colonoscopy screening based on a patient's age or other risk factors, using the invasive and preparation-intensive procedure to examine the colon and remove any precancerous polyps — which are found about 25 percent of the time. CRC ranks No. 2 for cancer deaths in the U.S.
By adopting a universal approach to screening that involves colonoscopy alternatives and broad access, however, the U.S. could significantly reduce the number of CRC cases and deaths, the experts concluded.
Five components of their proposed strategy:
1. Offering noninvasive testing upfront and integrating these alternatives with colonoscopy
2. Considering personal risk levels and involving the patient in decisions about the most appropriate testing options
3. Using colonoscopy when it would provide the greatest benefit, rather than as a default screening choice
4. Systematically initiating screening, follow-up testing and surveillance instead of relying on physician referrals
5. Ensuring at-risk individuals have access to appropriate screening regardless of social status, economic status or race
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