Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology

TLDR

Colorectal cancer is the third most common cancer and second leading cause of cancer death in the U.S., yet it can largely be prevented by detecting and removing adenomatous polyps, and survival improves when diagnosed while still localized. This update revises the organizations’ guidelines to categorize screening tests into those that primarily detect cancer early and those that also detect adenomatous polyps, thereby enhancing prevention through polypectomy. The guidelines, developed jointly by the American Cancer Society, the US Multi‑Society Task Force on Colorectal Cancer, and the American College of Radiology, recommend that clinicians present patients with all screening options, choosing between tests effective at both early cancer detection and polyp removal and those primarily effective at early cancer detection. The three organizations strongly assert that colon cancer prevention should be the primary goal of screening.

Abstract

In the United States, colorectal cancer (CRC) is the third most common cancer diagnosed among men and women and the second leading cause of death from cancer. CRC largely can be prevented by the detection and removal of adenomatous polyps, and survival is significantly better when CRC is diagnosed while still localized. In 2006 to 2007, the American Cancer Society, the US Multi Society Task Force on Colorectal Cancer, and the American College of Radiology came together to develop consensus guidelines for the detection of adenomatous polyps and CRC in asymptomatic average-risk adults. In this update of each organization's guidelines, screening tests are grouped into those that primarily detect cancer early and those that can detect cancer early and also can detect adenomatous polyps, thus providing a greater potential for prevention through polypectomy. When possible, clinicians should make patients aware of the full range of screening options, but at a minimum they should be prepared to offer patients a choice between a screening test that is effective at both early cancer detection and cancer prevention through the detection and removal of polyps and a screening test that primarily is effective at early cancer detection. It is the strong opinion of these 3 organizations that colon cancer prevention should be the primary goal of screening.