The American College of Physicians (ACP) has issued new guidelines for screening asymptomatic, adults at average-risk for colorectal cancer (CRC).

“Average-risk” means an adult who does not have any of the following:

• Family history of CRC
• History of CRC, noncancerous polyps, or inflammatory bowel disease
• Certain genetic syndromes

Hence, these guidelines are not applicable to persons with a family history of CRC, a long-standing history of inflammatory bowel disease, a genetic syndrome (such as familial adenomatous polyposis) or a personal history of CRC or adenomatous polyps. They are considered to be at above-average risk for CRC.

The key recommendations are:

• Screen for colorectal cancer in average-risk adults between the ages of 50 and 75 years.
• Select the colorectal cancer screening test with the patient on the basis of a discussion of benefits, harms, costs, availability, frequency, and patient preferences.
• Discontinue screening for colorectal cancer in average-risk adults older than 75 years or in adults with a life expectancy of 10 years or less.

The following screening tests are recommended

• Fecal immunochemical testing (FIT) or high-sensitivity guaiac-based fecal occult blood testing (gFOBT) every 2 years, or
• Colonoscopy every 10 years, or
• Flexible sigmoidoscopy every 10 years + fecal immunochemical testing every 2 years

The guidelines are published online Nov. 5, 2019 in the Annals of Internal Medicine.

(Source: Annals of Internal Medicine)

Dr KK Aggarwal

Padma Shri Awardee

President Confederation of Medical Associations in Asia and Oceania (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA