Colorectal cancer screening and surveillance: clinical guidelines and rationale-Update based on new evidence.

@article{Winawer2003ColorectalCS,
  title={Colorectal cancer screening and surveillance: clinical guidelines and rationale-Update based on new evidence.},
  author={Sidney J. Winawer and Robert H. Fletcher and Douglas K. Rex and John H. Bond and Randall W. Burt and Joseph T. Jr. Ferrucci and Theodore G Ganiats and Theodore R. Levin and Steven H. Woolf and David A. Johnson and Lynne M Kirk and Scott Litin and Clifford L. Simmang},
  journal={Gastroenterology},
  year={2003},
  volume={124 2},
  pages={
          544-60
        }
}
We have updated guidelines for screening for colorectal cancer. The original guidelines were prepared by a panel convened by the U.S. Agency for Health Care Policy and Research and published in 1997 under the sponsorship of a consortium of gastroenterology societies. Since then, much has changed, both in the research rature and in the clinical context. The present report summarizes new developments in this field and suggests how they should change practice. As with the previous version, these… 

Figures and Tables from this paper

Screening tests for colorectal cancer: A menu of options remains relevant

The rationale for caution in designating one screening test as “the best” is discussed and information on how new stool and serum tests can be used effectively to screen for CRC is presented.

ASGE guideline: colorectal cancer screening and surveillance.

Cascade Colorectal Cancer Screening Guidelines: A Global Conceptual Model

A new conceptual model of cascade colorectal cancer screening guidelines that is also evidence based but resource driven is presented that can be adapted to a variety of evidence-based options with consideration of available resources.

Practice Parameter for the Detection of Colorectal Neoplasms: An Interim Report (Revised)

A summary of the task force guidelines to serve as an interim updated practice parameter for colorectal cancer screening and two emerging technologies, including fecal DNA screening and CT colonography, are discussed at the end of this summary.

Colon cancer screening in 2005: status and challenges.

Current challenges are identified in light of the evolution of evidence, guidelines, and practice and to anticipate the next phase of development and implementation of colon cancer screening tests.

American College of Gastroenterology Action Plan for Colorectal Cancer Prevention

  • D. Rex
  • Medicine
    American Journal of Gastroenterology
  • 2004
This document represents the current plan of the ACG with regard to clinical practice, education and researching colonic imaging, and colorectal cancer prevention and focuses discussion on the currently dominant strategy, colonoscopy, and the two new strategies that have drawn the most attention.

Implications of New Colorectal Cancer Screening Technologies for Primary Care Practice

This article provides a summary of the newer CRC screening technologies that can be used by primary care physicians in shared decision making with their patients and discusses the tradeoffs among accuracy, costs, and patient preferences for the current and emerging CRC tests.

The Quebec Association of Gastroenterology position paper on colorectal cancer screening - 2003.

The Task Force recommended the establishment of a screening program with five- to 10- yearly double contrast barium enema or 10-yearly colonoscopy for individuals aged 50 years or older at low risk and formal feasibility, effectiveness and cost-effectiveness studies are now warranted.

Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society.

A careful analytic approach was designed addressing all evidence available in the literature to delineate predictors of advanced pathology, both cancer and advanced adenomas, so that patients can be more definitely stratified at their baseline colonoscopy into those at lower or increased risk for a subsequent advanced neoplasia.
...

References

SHOWING 1-10 OF 106 REFERENCES

Colorectal cancer screening: clinical guidelines and rationale.

This guideline report presents the panel’s recommendations with respect to screening and surveillance in people at average risk for CRC and those at increased risk because of a family history of CRC or genetic syndromes or a personal history of adenomatous polyps, inflammatory bowel disease, or curative-intent resection of CRC.

Cost-effectiveness of colonoscopy in screening for colorectal cancer.

Researchers compared the costeffectiveness of the three modalities used in primary screening for colorectal cancer: fecal occult blood testing, flexible sigmoidoscopy, and colonoscopy.

Choice of fecal occult blood tests for colorectal cancer screening: recommendations based on performance characteristics in population studies

There is now strong evidence that screening for colorectal cancer with fecal occult blood tests (FOBTs) is effective in reducing the incidence and mortality of this disease and there is no extensively studied FOBT that fulfills the needs for all target populations worldwide.

Endoscopic colorectal cancer screening: a cost-saving analysis.

It may well be that the induced savings by endoscopic colorectal cancer screening completely compensate for the costs, given the present, limited knowledge of the disease process of coloreCTal cancer, test characteristics, and costs.

Surveillance Issues in Inflammatory Bowel Disease: Ulcerative Colitis

An overview of the criteria for evaluating screening and surveillance programs and applies the criteria to the available evidence to determine the effectiveness of the surveillance of patients with ulcerative colitis is provided.

Screening for colorectal cancer with fecal occult blood testing and sigmoidoscopy.

The screening of average-risk individuals (aged 50 and older) for colorectal cancer through use of the fecal occult blood test in conjunction with sigmoidoscopy can increase the likelihood of early detection of this disease.

The effect of fecal occult-blood screening on the incidence of colorectal cancer.

The use of either annual or biennial fecal occult-blood testing significantly reduces the incidence of colorectal cancer.

Cost-effectiveness of screening for colorectal cancer in the general population.

Screening for CRC, even in the setting of imperfect compliance, significantly reduces CRC mortality at costs comparable to other cancer screening procedures, however, compliance rates significantly affect the incremental CE ratios.
...