Keystone Physician - Fall 2011 - (Page 60)
OPEN ACCESS ENDOSCOPY
Increasing Access for Colorectal Cancer Screening
By Thomas J. McGarrity, M.D. & Eileen Gagliardi, R.N., CGRN
ColoreCtal CanCer (CRC) remains the second leading cause of cancer deaths for men and women in Pennsylvania and throughout the United States. The five-year survival for colorectal cancer is 90 percent for localized disease, 68 percent for regional disease, and only 10 percent if distant metastasis is present. Recently, a decrease in colorectal cancer incidence and mortality has been documented, attributed in part to the beneficial effects of screening. The decreased incidence in CRC is due to the removal of premalignant adenomatous polyps at colonoscopy. Colonoscopy is one of the more common elective procedures done in the United States with up to 14 million colonoscopies performed in 2003. Convenient, one-stop, open access colonoscopy removes an important barrier to CRC screening. The multi-GI societies in cooperation with the American Cancer Society and the American College of Radiology divided CRC screening tests into those tests that (1) primarily are effective at detecting cancer and (2) those that are effective at detecting cancer and precancerous polyps. This group strongly recommended that colorectal cancer prevention tests, which include colonoscopy and sigmoidoscopy, should be the primary goal of colorectal cancer screening. The American College of Gastroenterology designated colonoscopy as the preferred strategy for CRC screening based on the colonoscopy’s effectiveness and acceptance by patients.
ColoreCtal CanCer SCreening
The screening recommendations for colorectal cancer were revised by multiple panels in 2008 and 2009. The U.S. Preventative Services Task Force (USPSTF) recommendations include: • screening all male and females, age 50-75 years, with • high sensitivity fecal occult blood tests annually, or • sigmoidoscopy every 5 years with interval fecal occult blood tests every 3 years, or • colonoscopy every 10 years.
60 | KeystonePhysician | Fall 2011
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