ASGE Annual GI Advanced Practice Provider Course - Day Two (On-Demand) | April 2022-25_Colorectal Cancer Screening Tests

25_Colorectal Cancer Screening Tests - Vicari

Pdf Summary

This document provides information on CRC (colorectal cancer) screening and alternative screening modalities. It highlights the growing rates of colon cancer in younger patients and the importance of prevention through screening. Despite the success of colonoscopy in detecting and preventing colon cancer, a significant number of eligible Americans are still not getting screened, citing reasons such as lack of mention by their doctors, access barriers, cost, and reluctance.<br /><br />The document discusses the risk factors for colon cancer that cannot be changed, such as age, race, personal and family history, as well as risk factors that can be changed, including diet, physical activity, weight management, and controlling diabetes, smoking, and alcohol use.<br /><br />Colonoscopy is described as the gold standard for colon cancer screening due to its ability to detect advanced lesions and prevent cancer. However, reasons for patient delay in getting colonoscopy include concerns about invasiveness, prep intolerance, safety, body image, logistics, and costs. The risks associated with colonoscopy, such as complications and bleeding, are also outlined.<br /><br />The document then discusses alternative screening modalities, such as the fecal immunochemical test (FIT) and the FIT-fecal DNA test (Cologuard). FIT is a stool test that checks for hemoglobin, and while it is low cost and easy to use, it is not as sensitive as colonoscopy and may require follow-up colonoscopy if positive. The FIT-fecal DNA test combines FIT with fecal DNA and methylation markers, and while it is easier than colonoscopy, it has limitations in its ability to detect colon cancers and polyps.<br /><br />The take-home points emphasize the importance of colon cancer screening, especially for average-risk patients, with colonoscopy remaining the preferred test. For patients who refuse colonoscopy, annual FIT testing is recommended, with the FIT-fecal DNA test as an alternative with limitations. Overall, any form of screening is better than no screening, but colonoscopy is still the only test that prevents cancer of the entire colon.

Keywords

CRC screening

colorectal cancer

alternative screening modalities

colonoscopy

risk factors

FIT

hemoglobin

follow-up colonoscopy

FIT-fecal DNA test

prevents cancer