Colonoscopy and sigmoidoscopy
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Colonoscopy and flex sig associated with lower CRC mortality- Yield for CRC screening: colonoscopy > flex sig >> FOBT
- Every-other-year FIT is at least as effective as a single sigmoidoscopy to detect colorectal cancer
- Flex sig screening effective for men of any age and women younger than 60 years
- CT colonography similar to colonoscopy at detecting advanced lesions
- Flex sig reduces incidence and mortality of colorectal cancer
- Simple score predicts risk of advanced proximal colon neoplasia
- Nonadvanced colon adenoma may not increase colorectal cancer risk
- Aspirin = screening to prevent colorectal cancer mortality
- Markov model: colonoscopy is most effective strategy in improving outcomes
- Once-only flex sig decreases 11-year cancer mortality
- Observational study finds lower colorectal CA-specific mortality with colonoscopy
- One-time flex sig at 60 associated with decreased CRC incidence, but not mortality (SCORE)
- Colonoscopy more than 10 months after positive FIT increases risk of colorectal cancer and more advanced-stage disease
- American College of Physicians: Screen for colon cancer using the test the patient chooses
- Fecal immunochemical testing more sensitive than guaiac testing
- ACP guidelines on screening for colon cancer
- Follow-up colonoscopy may not be necessary after acute uncomplicated diverticulitis
- USPSTF: No colon cancer screening after age 75 years
- CRC screening recommendations for average-risk and high-risk persons from US GI societies
- Benign course for symptomatic uncomplicated diverticular disease
- Consider not screening average-risk adults aged 45-49 years for colorectal cancer; stick to usual means of screening