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Best colon cancer screening is ‘the one that gets done’
ORLANDO — Despite the wide variety in guidelines for colorectal cancer, an expert at the Postgraduate Course prior to the World Congress of Gastroenterology at ACG 2017 said the best screening is ‘the one that gets done.’
“There are a number of guidelines available with ... variations [but] the best screening test is what gets done and gets done well,” Roque Sáenz, MD, FACG, chair of gastroenterology at the Clinica Alemana in Santiago, Chile, said during his presentation.
He laid out U.S. guidelines vs. European guidelines vs. Asia-Pacific guidelines and showed the differences between average risk and high-risk patients.
Sáenz pointed to three ways to screen: structural exams like colonoscopy, noninvasive stool-based tests like fecal occult blood testing (FOBT) or genetic markers and serum-based tests. Yet, he said the global guidelines differ on preferences for the average risk patient and even for those at higher risk.
“Few programs out of the U.S. utilize colonoscopy for the first line screening in average risk populations,” he explained. Most, instead, use fecal immunochemical testing (FIT), FOBT or flexible sigmoidoscopy.
Sáenz returned to his theme of increasing the number of patients screened.
“The key issue in the problem of screening for CRC is the more candidates for screening we recruit, the more favorable effect with any screening modality so that is one of our tasks – to recruit the candidates,” Sáenz said.
He went on to suggest that while the guidelines for follow-up are important, perhaps it is more important for physicians to screen those who have not been screened.
“CRC prevention is an important task for all of us. Not only doctors but also the community. We should increase the number of people screened just to avoid colon cancer. The best method for colorectal cancer prevention is the one that gets done well,” Sáenz said. “We should say that the incidence and mortality for CRC screening is declining when the program for CRC screening is working. CRC is the third most common cause of cancer worldwide. It’s preventable if adenomas are detected and removed. It’s curable if CRC is detected early. The best test is the one that gets done well and with appropriate follow-up.” – by Katrina Altersitz
Reference: Sáenz R. Postgraduate Course. Presented at: World Congress of Gastroenterology at American College of Gastroenterology Annual Scientific Meeting; Oct. 13-18, 2017; Orlando, FL.
Disclosures: Saenz reports no relevant financial disclosures.