ASGE Endoscopy Live: Colonoscopy Symposium | September 2022-Endoscopy Live Presentation 4 - Update on Colonoscopy Screening and Surveillance Guidelines

Endoscopy Live Presentation 4 - Update on Colonoscopy Screening and Surveillance Guidelines

Video Transcription

Video Summary

In this video, Charles Kahi from Indiana University provides an update on colonoscopy screening and surveillance guidelines. He discusses the success of colorectal cancer screening in the United States and the decreasing trends in colorectal cancer incidence in individuals aged 50 to 65. However, he highlights an alarming reverse trend in individuals younger than 50, with increasing incidence rates, particularly for rectal cancer. The video emphasizes that early adult-onset colorectal cancer may be a disease of affluence and is seeing a birth cohort effect, where successive generations carry forward an increased risk. Kahi reviews the new guidelines which recommend starting screening at age 45, supported by retrospective data showing its effectiveness. He also discusses when to stop screening and surveillance, with most organizations providing qualified recommendations based on patient health and life expectancy. Additionally, Kahi covers the importance of surveillance colonoscopy in preventing colorectal cancer cases and highlights the updated guidelines for post-polypectomy surveillance, including intervals for different adenoma findings and serrated polyps. The video concludes with key take-home points, including the need to pay attention to younger patients with symptoms, the consideration of health-adjusted life expectancy in screening decisions after age 75, and the de-intensification of surveillance in individuals with low-risk polyps.

Keywords

colonoscopy screening

surveillance guidelines

colorectal cancer

incidence rates

early adult-onset colorectal cancer