Masterclass: Colorectal Screening Plus (Virtual) | September 2025-Q and A Session 1

Video Transcription

Video Summary

In this colorectal cancer screening discussion, experts emphasize colonoscopy by gastroenterologists due to higher adenoma detection rates compared to non-gastroenterologists, though quality overlaps across specialties. The CONFIRM study is evaluating if colonoscopy is superior to FIT stool testing, with current recommendations favoring colonoscopy or FIT as Tier 1 tests. Blood-based tests are reserved for those refusing standard methods, as widespread switching could increase cancer incidence. Timely colonoscopy after positive stool tests is critical; delays beyond 6-9 months raise cancer risks, yet completion rates are suboptimal. Quality metrics such as adenoma detection rates and withdrawal times are vital for practitioners, with newer guidelines and technologies evolving. Surveillance after low-risk adenoma removal remains under study, with some international guidelines endorsing FIT instead of colonoscopy, though U.S. practice still relies on colonoscopy. Addressing insurance-driven inappropriate stool test distribution requires improved integration and communication among providers to ensure appropriate screening and follow-up.

Keywords

colorectal cancer screening

colonoscopy

adenoma detection rate

FIT stool testing

cancer screening guidelines