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CRC Screening Guideline Adherence Low

John Commins, for HealthLeaders Media, October 18, 2010

Most doctors don't follow practice guidelines for recommending colorectal cancer screenings, a study shows.

The survey of nearly 1,300 primary care physicians in the United States found that only about 20% of them recommend colorectal cancer screenings tests to their patients in accordance with current practice guidelines. About 40% of the doctors followed some of the practice guidelines, while the remaining 40% ignore practice guidelines.

NCI investigator Robin Yabroff said the survey suggests that by not using practice guidelines, many physicians either overuse or underuse screening tests. The underuse of CRC screenings may result in fewer earlier stage or pre-invasive cancers being detected, while overuse of screening results in expensive, unnecessary screenings and puts patients at risk for certain types of screening-related complications. The study results appeared Oct.14, in the Journal of General Internal Medicine.

CRC screening guidelines have been developed by the several groups, including the U.S. Preventive Services Task Force. The guidelines recommend screening for CRC using high-sensitivity fecal occult blood testing, flexible sigmoidoscopy, double-contrast barium enema, or colonoscopy. Initiating screening at age 50 is recommended, although the time between screenings varies.

Having multiple modalities available for screening allows physicians and patients to consider the risks, benefits and other attributes of CRC screening tests and to ultimately identify the option best suited to the patient. However, multiple screening modalities may also contribute to confusion about their appropriate use by physicians and patients.


John Commins is a senior editor with HealthLeaders Media.

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