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Recommendations Developed for CRC Screening in Primary Care

Screening with gFOBT or flexible sigmoidoscopy reduces incidence of late-stage CRC, mortality

TUESDAY, Feb. 23, 2016 (HealthDay News) — Recommendations have been developed for colorectal cancer screening in primary care. The guidelines were published online Feb. 22 in CMAJ, the journal of the Canadian Medical Association.

C. Maria Bacchus, M.B.B.S., Ph.D., from the University of Calgary in Canada, and colleagues on the Canadian Task Force on Preventive Health Care, developed recommendations on screening for colorectal cancer in primary care.

The authors note that based on data from randomized controlled trials (RCTs), screening with guaiac fecal occult blood testing (gFOBT) or flexible sigmoidoscopy reduces the incidence of late-stage colorectal cancer and colorectal cancer mortality. Relative benefits of screening appear to be similar for those aged 60 to 74 years and 50 to 59 years; however, the absolute benefits are larger for older adults due to the higher incidence of colorectal cancer. Fecal immunochemical testing has greater sensitivity than gFOBT, with similar specificity; neither test has direct substantial harms, apart from those associated with follow-up investigations and therapy. The mortality benefit of screening colonoscopy, computed tomographic colonography, barium enema, digital rectal examination, or fecal DNA testing have not been reported in RCTs. When choosing a screening test, resources, test availability, and patient preferences should be considered.

“Regardless of age, primary care providers should discuss the most appropriate choice of test with patients who are interested in screening, considering patient values and preferences as well as local test availability,” the authors write.

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