No data to support leaving small colon polyps in place

to increase screening rates, we cannot lose sight of the importance of providing patient care that is based on evidence. Right now, the data to support leaving small polyps in place is lacking.

CT colonography is an emerging technology that shows promise, but it is not widely available. Medicare and most insurance companies do not cover the test for colon cancer screening. Many practical issues associated with CT colonography still need to be addressed including standardization of test performance, patient preparation and interpretation of test results before CT colonography can be recommended for routine clinical practice. If a polyp that needs removal is found during CT colonography, the patient must then undergo a colonoscopy. Some patients might find it more convenient to have a single definitive optical colonoscopy. Additionally, after a patient has a negative colonoscopy, there are studies that show that it is possible to wait for 10 years for subsequent screening. There is no information on whether it is safe to wait 10 years between CT colonographies.

Patients should not put off screening for colorectal cancer and polyps. All adults should discuss options with their physicians and be certain of their life-time risk for colon cancer. People with a family history that includes colon cancer are at higher risk, as are certain racial and ethnic populations and people with inflammatory bowel disease or previous colon polyps or cancer. By age 50, all adults should undergo one of the colorectal cancer screening tests currently available to them, says Dr. Allen.

Guidelines of multiple agencies and professional societies, including the AGA Institute, underscore the importance of screening for all individuals 50 years of age and older (younger for certain groups known to be at higher risk). Currently, there are several tests that may be used to screen for colorectal cancer, the second-leading cause of cancer deaths in the United State

Contact: Aimee Frank
American Gastroenterological Association

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