How soon should average risk people get another colorectal cancer screening after they have a normal colonoscopy?

No sooner than 10 years, the American Gastroenterological Association recommends as part of the Choosing Wisely campaign.

The AGA’s list of Five Things Physicians and Patients Should Question includes:

1. Use the lowest possible effective dose of acid reducing medicines to treat gastroesophageal reflux disease (GERD).
2. After a negative, quality colonoscopy, don’t repeat colorectal cancer screening by any method for 10 years.
3. After removing 1 or 2 small (less than 1 centimeter) adenomatous polyps without signs of cellular change (dysplasia), don’t repeat the colonoscopy for at least 5 years.
4. After two endoscopies without dysplasia, people with Barrett’s esophagus shouldn’t have another upper endoscopy for at least 3 years.
5. Patients with abdominal pain shouldn’t have a repeat CT scan unless there are major changes in symptoms or clinical findings.

AGA’s list is based on current published recommendations for the time between colonoscopy and endoscopy in people with low risks for cancer.

The Choosing Wisely campaign wants doctors and patients to talk together about tests and treatments that are supported by evidence, don’t duplicate other tests or procedures, are free from harm, and are truly necessary.

Ask your doctor, “Do I really need this test?” and “Do I need it now?”

Oncologists have joined eight other physician specialty organizations in the Choosing Wisely® campaign with a list of the Top Five Cancer-Related Tests, Procedures, and Treatments That Many Patients Do Not Need.

Choosing Wisely asked each of the specialist groups to come up with a list of five things doctors and patients should question in order to improve evidence-based care, avoid tests or treatments that don’t help, and reduce the burden of health care costs. Here are the Top Five lists from the other groups.

The American Society of Clinical Oncology  built the Top Five List for Oncology, based on work that ASCO’s Cost of Care Task Force has been doing for several years to identify diagnostic tests or treatments that are commonly ordered, expensive, and of unproven value.

While the Top Five list is based on evidence for effective cancer care, its recommendations are not written in stone. They are guidelines for patients, families, and doctors to begin a conversation about tests and treatments and costs in order to make good decisions about the best care for each individual.

Briefly the Top Five list recommends

1. Stop active cancer treatment when patients are too ill to benefit, aren’t eligible for a clinical trial, previous treatments haven’t worked, and there are no more standard treatment options.
2. Don’t use advanced imaging tests (CT, PET, bone scans) for early prostate cancer which has a low risk of spreading.
3. Don’t use similar imaging tests for early breast cancer that has a low risk of spreading.
4. Don’t use PET, CT, bone scans or biomarkers to follow-up breast cancer patients without symptoms after treatment intended to cure them.
5. Don’t give medicines to stimulate white cells in patients with a low risk of developing low counts with fever.

More specifically the Top Five for Oncology published ahead of print in the Journal of Clinical Oncology April 3  are: Read the rest of this entry »