Colorectal cancer deaths can be reduced if a new model of screening that uses risk assessment, non-invasive testing, and targeted referrals for colonoscopy is used, according to a new article published by the American Gastroenterological Association (AGA). 

The paper, titled “Roadmap for the Future of Colorectal Screening in the United States,” discusses how to best manage colorectal cancer, which is the second deadliest cancer in the United States. Colorectal cancer is highly preventable and, when caught early, very treatable; however, at least 1 in 4 Americans who should be screened for colorectal cancer have not been, according to the paper. 

The findings include the recommendations of 60 experts in gastroenterology and research in an effort to determine how to reach the full potential of screening capabilities. They concluded that in order to reduce deaths and cases, a universal screening approach should be adopted, according to the paper. In addition, alternatives to a colonoscopy should be offered. 

The new approach proposed in the paper recommends offering noninvasive testing up front, such as stool testing. For those who are at a higher risk, a colonoscopy would be recommended, whereas those who are low-risk would have an initial non-invasive test. 

A colonoscopy should only be used when it would provide the greatest benefit, rather than as a default. Currently, 2 noninvasive tests are available—the fecal immunochemical test and the multi-target stool DNA test. It is also important to ensure that there are no barriers, such as social, racial or economic disparities, to testing. Those who with the greatest risk should have readily available testing, according to the paper.   

"Approximately 67% of eligible Americans are screened for colorectal cancer. We need to improve our strategies to curb the cancer that ranks second for deaths in the US…AGA is proud to introduce this white paper—the first step in our mission to develop a more structured screening program that can increase screening rates, catch more colorectal cancers early, and save countless lives,” Chair of the AGA Center for GI Innovation and Technology, Sri Komanduri, MD, AGAF, said in a press release.

An increase in non-invasive screening can also help to improve access to a colonoscopy among those who are most at risk, according to the press release. Electronic health records can help physicians conduct a more accurate risk-assessment for their patients. 

Reference:

Roadmap to reducing colorectal cancer deaths (news release), Chicago, IL. August 3, 2020 EurekAlert! Accessed August 6, 2020