Screening for colorectal cancer has been shown to reduce the mortality associated with this common disease; colonoscopy provides the opportunity to detect and remove adenomatous polyps, the precursor lesion to many cancers, thereby reducing the incidence of the disease later in life. However, screening and surveillance modalities are inappropriate when the risks exceed the benefit. The risk of colonoscopy increases with increasing age and comorbidities. The risk/benefit ratio of colorectal cancer screening or surveillance for any patient should be individualized based on the results of previous screening examinations, family history, predicted risk of the intervention, life expectancy and patient preference.
Sources:
Lieberman DA, et al. Guidelines for colonoscopy surveillance after screening and polypectomy: A consensus update by the US multi-society task force on colorectal cancer. Gastroenterology. 2012 Sep;143(3):844-57. PMID: 22763141.
Qaseem A, et al. Screening for colorectal cancer: A guidance statement from the American College of Physicians. Ann Intern Med. 2012 Mar 6;156(5):378-86. PMID: 22393133.
U.S. Preventive Services Task Force. Screening for colorectal cancer: U.S. preventive services task force recommendation statement. Ann Intern Med. 2008 Nov 4;149(9):627-37. PMID: 18838716.
Warren JL, et al. Adverse events after outpatient colonoscopy in the medicare population. Ann Intern Med. 2009 Jun 16;150(12):849-57, W152. PMID: 19528563.
Related Resources:
Canadian Task Force on Preventive Health Care: Screening for Colorectal Cancer (CRC)