Cancer Screening In Average-risk Individuals Research Articles

Guaiac-based faecal occult blood tests versus faecal immunochemical tests for colorectal cancer screening in average-risk individuals

This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: GrobbeeEJ, WissePHA, SchreudersEH, van RoonA, van DamL, ZauberAG, Lansdorp-VogelaarI, BramerW, BerhaneS, DeeksJJ, SteyerbergEW, van LeerdamME, SpaanderMCW, KuipersEJ. Guaiac-based faecal occult blood tests versus faecal immunochemical tests for colorectal cancer screening in average-risk individuals. Cochrane Database of Systematic Reviews. 2022. Issue6. Art. No.: CD009276. doi: 10.1002/14651858.CD009276.pub2

Interpretation of updated guidelines for colorectal cancer screening in average-risk individuals in the United States

In recent years, due to changes in the epidemiology of colorectal cancer in the United States, the update of evidence-based medical evidence for screening, and the emergence of various new screening methods, various organizations in the United States, such as American College of Gastroenterology、Preventive Services Task Force, have updated guidelines for colorectal cancer screening in average-risk individuals. These guidelines have different recommendation levels in terms of starting and ending age, screening methods and frequency for colorectal cancer screening. A comprehensive understanding of the key points of these guideline updates and the similarities and differences recommended by different guidelines has important reference value for the colorectal cancer screening in China.

Guaiac-based faecal occult blood tests versus faecal immunochemical tests for colorectal cancer screening in average-risk individuals.

Guaiac-based faecal occult blood tests versus faecal immunochemical tests for colorectal cancer screening in average-risk individuals.

Mo1156 Meta-Analysis on Guaiac-Based Fecal Occult Blood Tests Versus Fecal Immunochemical Tests for Colorectal Cancer Screening in Average-Risk Individuals

Mo1156 Meta-Analysis on Guaiac-Based Fecal Occult Blood Tests Versus Fecal Immunochemical Tests for Colorectal Cancer Screening in Average-Risk Individuals

Targeted Cancer Screening in Average-Risk Individuals.

Targeted cancer screening refers to use of disease risk information to identify those most likely to benefit from screening. Researchers have begun to explore the possibility of refining screening regimens for average-risk individuals using genetic and non-genetic risk factors and previous screening experience. Average-risk individuals are those not known to be at substantially elevated risk, including those without known inherited predisposition, without comorbidities known to increase cancer risk, and without previous diagnosis of cancer or pre-cancer. In this paper, we describe the goals of targeted cancer screening in average-risk individuals, present factors on which cancer screening has been targeted, discuss inclusion of targeting in screening guidelines issued by major U.S. professional organizations, and present evidence to support or question such inclusion. Screening guidelines for average-risk individuals currently target age; smoking (lung cancer only); and, in some instances, race; family history of cancer; and previous negative screening history (cervical cancer only). No guidelines include common genomic polymorphisms. RCTs suggest that targeting certain ages and smoking histories reduces disease-specific cancer mortality, although some guidelines extend ages and smoking histories based on statistical modeling. Guidelines that are based on modestly elevated disease risk typically have either no or little evidence of an ability to affect a mortality benefit. In time, targeted cancer screening is likely to include genetic factors and past screening experience as well as non-genetic factors other than age, smoking, and race, but it is of utmost importance that clinical implementation be evidence-based.

Addressing overuse and overdiagnosis in colorectal cancer screening for average-risk individuals

SUMMARY Inappropriate screening harms healthy individuals and squanders precious resources. The purpose of this review is to address harms of colorectal cancer screening derived from overuse and overdiagnosis in average-risk individuals. Overuse is associated with shorter than recommended repeat screening and surveillance intervals, and screening in individuals who would not derive benefit because of advanced age or significant comorbidity. Overuse can unnecessarily increase patient harm from overdiagnosis or colonoscopy complications as well as gastroenterologist workload and healthcare costs. There is no evidence to suggest that overdiagnosis is an issue for colorectal cancer screening. However, targeting on cancer prevention (detection of adenomatous polyps) rather than early detection will lead to overdiagnosis as only a small minority of polyps develop into cancer.

ACR Appropriateness Criteria Colorectal Cancer Screening

Colorectal cancer is the third leading cause of cancer deaths in the United States. Most colorectal cancers can be prevented by detecting and removing the precursor adenomatous polyp. Individual risk factors for the development of colorectal cancer will influence the particular choice of screening tool. CT colonography (CTC) is the primary imaging test for colorectal cancer screening in average-risk individuals, whereas the double-contrast barium enema (DCBE) is now considered to be a test that may be appropriate, particularly in settings where CTC is unavailable. Single-contrast barium enema has a lower performance profile and is indicated for screening only when CTC and DCBE are not available. CTC is also the preferred test for colon evaluation following an incomplete colonoscopy. Imaging tests including CTC and DCBE are not indicated for colorectal cancer screening in high-risk patients with polyposis syndromes or inflammatory bowel disease. This paper presents the updated colorectal cancer imaging test ratings and is the result of evidence-based consensus by the ACR Appropriateness Criteria Expert Panel on Gastrointestinal Imaging. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Guaiac-based faecal occult blood tests versus faecal immunochemical tests for colorectal cancer screening in average-risk individuals

Guaiac-based faecal occult blood tests versus faecal immunochemical tests for colorectal cancer screening in average-risk individuals

ACR Appropriateness Criteria® on Colorectal Cancer Screening

Colorectal cancer remains one of the most common causes of cancer death in this country. This malignancy is ideally suited for screening because the detection and removal of the precursor adenomatous polyp can prevent most colorectal cancers from ever forming. The choice of a test for screening involves consideration of various individual parameters, including patient age and the presence of risk factors for the development of colorectal cancer. Computed tomographic colonography (CTC) has emerged as the leading imaging technique for colorectal cancer screening in average-risk individuals on the basis of the evidence presented in this paper. The double-contrast barium enema is an alternative imaging test that is appropriate particularly when CTC is not available. In 2008, the American Cancer Society guideline for colorectal cancer screening was revised jointly with the US Multi-Society Task Force on Colorectal Cancer and the ACR to include CTC every 5 years as an option for average-risk individuals. Computed tomographic colonography is also the preferred test for colon evaluation after an incomplete colonoscopy. Imaging tests including CTC and the double-contrast barium enema are usually not indicated for colorectal cancer screening in high-risk patients with polyposis syndromes or inflammatory bowel disease. This paper presents the new colorectal cancer imaging test ratings and is the result of evidence-based consensus by the ACR Appropriateness Criteria Expert Panel on Gastrointestinal Imaging.

Colonoscopy Screening Yields in Average-Risk Individuals Aged 40 to 49

Essentially all guidelines recommend colorectal cancer screening in average-risk individuals starting at age 50. A previous study examining colonoscopy suggested that screening was not justified in average-risk individuals aged 40 to 49 because they had lower overall risk for adenomas and advanced adenomas than did older populations (N Engl J Med 2002; 346:1781). In the current study, researchers examined yields from 905 …