Guidelines

ACG: CRC screening should start at age 45


 

Quality indicators

For endoscopists who perform colonoscopy, the ACG recommended that all operators determine their individual cecal intubation rates, adenoma detection rates, and withdrawal times. They also recommended that endoscopists spend at least 6 minutes inspecting the mucosa during withdrawal and achieve a cecal intubation rate of at least 95% for all patients screened.

The ACG recommended remedial training for any provider whose adenoma detection rate is less than 25%.

Screening rates dropped during pandemic

The authors of the new recommendations also pointed out that, despite public health initiatives to boost CRC screening in the United States and the availability of multiple screening modalities, almost one-third of individuals who are eligible for CRC screening do not undergo screening.

Moreover, the proportion of individuals not being screened has reportedly increased during the pandemic. In one report, claims data for colonoscopies dropped by 90% during April. “Colorectal cancer screening rates must be optimized to reach the aspirational target of >80%,” the authors emphasized.

“A recommendation to be screened by a PCP [primary care provider] – who is known and trusted by the person – is clearly effective in raising participation,” they added.

Dr. Shaukat has served as a scientific consultant for Iterative Scopes and Freenome. Other ACG guideline authors reported numerous financial relationships.

A version of this article first appeared on Medscape.com.

Pages

Recommended Reading

Endoscopic CRC resection carries recurrence, mortality risks
MDedge Internal Medicine
Color-imaging endoscopy improves detection of upper GI cancer
MDedge Internal Medicine
PCPs play a small part in low-value care spending
MDedge Internal Medicine
Combo testing improves CRC screening participation, but not advanced disease detection
MDedge Internal Medicine
High cost of pancreatic enzymes a barrier for patients with cancer
MDedge Internal Medicine
FDA alert confirms heart and cancer risks with tofacitinib (Xeljanz)
MDedge Internal Medicine
Checkpoint inhibitors’ ‘big picture’ safety shown with preexisting autoimmune diseases
MDedge Internal Medicine
Can smoke exposure inform CRC surveillance in IBD?
MDedge Internal Medicine
Missed visits during pandemic cause ‘detrimental ripple effects’
MDedge Internal Medicine
HBV viremia linked to HCC risk in HIV/HBV coinfection
MDedge Internal Medicine