Dr David Johnson on the risks of younger patients moving toward FIT screening and away from colonoscopy. CRCSM
in 2021, to change their recommendations regarding colon cancer prevention screening from an average-risk age of 50 to 45 years. This certainly opened up a large new avenue for screening of another 19 million or so patients in the 45- to 49-year age range.
We can strive to apply the best recommendations, but ultimately a large factor in our screening practices will come down to what our patients prefer.just published from a group of researchers at the University of California, Los Angeles. They conducted an online survey of 1000 patients who were stratified into cohorts of those aged 40-49 years and ≥ 50 years. These patients were asked about their preferences among the five US Multi-Society Task Force recommendedscreening tests, including fecal immunochemical test every year, FIT-fecal DNA every 3 years, colon video capsule every 5 years , CT colonography every 5 years, or colonoscopy every 10 years. They found that the preference was consistent for multitargeted FIT-fecal DNA testing in both the 40-49 years and ≥ 50 years cohorts . Comparatively, colonoscopy every 10 years, which we would accept as the gold standard for prevention, had a preference rate of 13.7% and 13.6% in these cohorts, respectively. In another sign that patients are perhaps starting to acquiesce to convenience over efficacy, in a comparison of the US-MSTF's tier 1 tests — colonoscopy every 10 years or the stay-home FIT test every year — participants uniformly preferred the latter. Annual FIT testing was preferred by 68.9% in the 40-49 years cohort and 77.4% in those aged ≥ 50 years, compared with only 31.1% and 22.6%, respectively, for colonoscopy.I think these results mean that we're losing some ground when it comes to our messaging. We can't base everything on one study, but it certainly is a wake-up call to clinical practices, national societies, and medical organizations. We need to be reaching out to millennials and certainly to the patients who are not yet screened. We need to make sure that they understand that colonoscopy is the only test that we have that's preventive. Even the multitargeted stool DNA test misses 60% of advanced lesions, and FIT misses 95% of advanced lesions as it relates to sessile serrated polyps. When you talk about a 5% detection rate, that's within the element of chance. We need to start looking at what we've done in the past and reassess our messaging going forward. I'm not sure that the conventional wisdom that patients will come to us for a colonoscopy because it's the best test will sustain our screening strategies going forward. The best screening strategy, obviously, is the one that gets the test done. But the one that results in the best screening is the one that prevents colon cancer. We need to start looking at this very strongly and revise our marketing messages, our social media, and our educational campaigns around some of these new perspectives. Some of these findings may be tainted a little bit by the effects of COVID-19 and roughly 2 years of staying at home and away from elective procedures. But regardless, it's a wake-up call and we need to take perspective and put some plans into action. Otherwise, we're going to lose further ground. I'm concerned about this information, and hopefully you understand that you should be too.a regular contributor to Medscape , is professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Virginia, and a past president of the American College of Gastroenterology. His primary focus is the clinical practice of gastroenterology. He has published extensively in the internal medicine/gastroenterology literature, with principal research interests in esophageal and colon disease, and more recently in sleep and microbiome effects on gastrointestinal health and disease.
Please follow us on Google to support usUnited States Latest News, United States Headlines
Similar News: You can also read news stories similar to this one that we have collected from other news sources.
David Dobrik Says YouTuber Jeff Wittek Knew Excavator Stunt Gone Wrong Was RiskyDavid Dobrik says YouTuber Jeff Wittek knew the risks of excavator stunt gone wrong.
Read more »
Chicago Bears RB David Montgomery, WR Byron Pringle depart game against Houston Texans with injuriesWho do the Bears play today? Chicago RB David Montgomery suffered an injury during the Houston Texans game at Soldier Field.
Read more »
David Brooks: How do you handle a wounded Putin?David Brooks: “The world shifted this week. Vladimir Putin showed that he knows how deeply wounded he is.”
Read more »
David Foster, Bryan Adams, Alanis Morissette & More Inducted Into Canadian Songwriters Hall of FameFoster, who was inducted into the New York-based Songwriters Hall of Fame in 2010, was the first inductee of the night,
Read more »
Bears' Khalil Herbert Dedicates Big Game to David MontgomeryKhalil Herbert came in after David Montgomery went down with knee and ankle injuries and did a great job picking up the slack in the Bears run offense.
Read more »