Colorectal Cancer Screening Project | 2023-3_The Implications of Lack of Follow-up after Abnormal Stool-Based CRC Screening

Pdf Summary

The document discusses the implications of the lack of follow-up after abnormal stool-based colorectal cancer (CRC) screening. It mentions the various CRC screening modalities recommended by the United States Preventive Services Task Force (USPSTF) for average-risk adults of different age groups. These screening strategies include high-sensitivity FOBT, annual fecal immunochemical test (FIT), and stool DNA-FIT every 1-3 years.<br /><br />The document highlights the importance of follow-up after abnormal stool tests and outlines the clinical steps involved in the diagnostic process. It emphasizes the need for quality improvement measures and adherence to the recommended follow-up protocol.<br /><br />The lack of follow-up after abnormal stool tests has significant clinical implications. Studies cited in the document show that non-completion of colonoscopy and non-adherence to follow-up increase the risk of CRC-related death and late-stage CRC. It also mentions that delayed follow-up has been associated with higher CRC incidence and later stage at diagnosis.<br /><br />The document references several studies conducted in different countries, including the United Kingdom, Taiwan, and Italy, which provide evidence for the increased risk of CRC-related death among those who do not comply with colonoscopy after abnormal FIT results.<br /><br />Additionally, the document presents a retrospective cohort study from the Veterans Affairs (VA) system and a systematic review that support the importance of timely colonoscopy after abnormal fecal screening.<br /><br />In conclusion, the lack of follow-up after abnormal stool-based CRC screening has serious consequences and can lead to increased mortality and advanced disease. The document stresses the need for healthcare providers and patients to prioritize timely and appropriate follow-up to ensure early detection and intervention for CRC.

Asset Subtitle

Folasade May, MD, PhD, MPhil

Keywords

implications

follow-up

abnormal stool-based CRC screening

CRC screening modalities

average-risk adults

adherence

CRC-related death

delayed follow-up

increased risk

early detection