Only one in five primary care doctors in the U.S. follows all the guidelines for colorectal cancer screening, according to a new National Cancer Institute (NCI) study. Of the remaining doctors studied, about 40 percent followed guidelines for some tests; the remaining 40 percent didn’t follow any screening guidelines.
Robin Yabroff, PhD, an NCI epidemiologist, said that the survey of nearly 1,300 primary care physicians showed that many either overuse or underuse screening tests.
Most doctors did recommend initial screening at age 50, and many followed suggested intervals for a specific test. But only 19 percent followed guidelines for every type test.
The guidelines are complicated by the fact that there are four different types of routine screening (fecal or stool tests, colonoscopy, sigmoidoscopy, or barium enema), each with different recommended intervals, and several different organizations have suggested guidelines.
The good news: more people are getting screened. The challenge is for doctors to stay updated with the latest recommendations, and for patients to ask for screening.
What This Means for Individuals
The bottom line: Make a plan with your doctor.
- Routine screening guidelines only apply if you have no symptoms or risk factors. If you have a family history of colon or rectal cancer, or a history of ulcerative colitis or Crohn’s disease, you will likely need more frequent screening, or to start before age 50.
- Because they detect cancer but not precancerous lesions, annual fecal (stool) tests must be done faithfully every year. For colonoscopy, you must do careful pre-test preparation for the most accurate results.
- Don’t wait until the next scheduled screening if you develop symptoms (e.g., changed bowel habits or stools, unexplained abdominal symptoms, fatigue, rectal bleeding or dark stools).
- Read about the current guideline recommendations or call the Colorectal Cancer Coalition Answer Line at 877-4CRC-111.
SOURCE: Online edition of the Journal of General Internal Medicine, Oct. 14, 2010
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