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Colorectal Cancer Screening

The AAFP recently streamlined its stance on colorectal cancer screening. The new policy continues to strongly recommend screening men and women 50 years of age or older for the disease but gives no specifics on how often screening should be performed or what methods should be used. The changes were based on recommendations from the U.S. Preventive Services Task Force (USPSTF), which found good evidence that periodic at-home fecal occult blood testing (FOBT) reduced mortality rates from colorectal cancer and fair evidence that sigmoidoscopy alone or in combination with FOBT did so. Although the USPSTF found no direct evidence that screening colonoscopy reduced mortality rates, the overall efficacy of colonoscopy was supported by other data and evidence of benefit. Double-contrast barium enema offered an alternative means of whole-bowel examination but was less sensitive than colonoscopy and also showed no direct evidence of effectiveness in reducing mortality. Data were insufficient to indicate whether newer technologies such as computed tomographic colography improved outcomes. The new AAFP policy is available online at http://www.aafp.org/x24976.xml.

COPYRIGHT 2005 American Academy of Family Physicians
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