From Physician's First Watch (NEJM Journal Watch), February 23, 2016:
Canadian Guidelines Recommend Against Colonoscopy for Cancer Screening in Average-Risk Patients
By Cara Adler
Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD
The Canadian Task Force on Preventive Health Care now recommends against using colonoscopy as a primary screening tool in asymptomatic adults aged 50 and older who are not at high risk for colorectal cancer (weak recommendation). The group says there's inadequate evidence of colonoscopy's superiority to other screening tests, particularly fecal immunochemical testing (FIT).
Among the other recommendations for average-risk patients, published in the Canadian Medical Association Journal:
~Adults aged 50–74 should be screened every 2 years with either guaiac fecal occult blood testing (gFOBT) or FIT, or every 10 years with flexible sigmoidoscopy (strong recommendation for those aged 60–74; weak recommendation for those aged 50–59).
~Adults aged 75 and older should not be screened (weak recommendation).
In contrast, in its 2015 draft guidance for screening adults aged 50–75, the U.S. Preventive Services Task Force recommends colonoscopy every 10 years; FIT or gFOBT annually; or flexible sigmoidoscopy every 10 years plus FIT annually.
The Canadian authors suggest that primary care providers offer screening to all patients aged 60–74, discuss benefits and harms with those aged 50–59, and consider individual preferences in patients aged 75 and older.
The article can be seen
here.