MarylandEvery man and woman age 50 or older with an average risk of colorectal
cancer should be screened for colorectal cancer periodically, according to a
new and strong recommendation from the US Preventive Services Task Force (USPSTF).
The panel’s report also said screening for the disease at an earlier age in
people at high risk is a reasonable practice.
"The USPSTF found fair to good evidence that several
screening methods are effective in reducing mortality from colorectal cancer,"
the report said. "The USPSTF concluded that the benefits from screening
substantially outweigh potential harms, but the quality of evidence, magnitude
of benefit, and potential harms vary with each method."
The panel is an independent group of experts sponsored by
the Agency for Healthcare Research and Quality (AHRQ) that makes
recommendations across the prevention spectrum. Its recommendations do not
represent federal policy but are widely accepted within medicine. It made its
new recommendations after reviewing an updated evaluation of the scientific
literature pertaining to colorectal screening techniques.
"The USPSTF found good evidence that periodic fecal occult
blood testing (FOBT) reduces mortality from colorec-tal cancer and fair
evidence that sigmoidoscopy alone or in combination with FOBT reduces
mortality," the report said.
Although the panel did not find direct evidence that
colonoscopy reduced colorectal cancer mortality, its efficacy "is supported by
its integral role in trials of FOBT, extrapolation from sigmoi-doscopy studies,
limited case-control evidence, and the ability of colonoscopy to inspect the
Double-contrast barium enema offers an alternative to
whole-bowel examination, but its sensitivity is below that of colonoscopy, and
no direct evidence supports its efficacy in reducing mortality, the USPSTF
It also found insufficient evidence that newer screening
techniques, such as computed tomographic colography (also known as virtual
colonoscopy), improve the outcomes of patients with colorectal cancer. CT
colography has proven relatively sensitive and specific in research
settings85% to 90%but recent reports suggest a lower accuracy when performed
by less experienced practitioners.