Stratified guidelines emphasize optimal detection methods and treatments of colorectal cancer
FRIDAY, March 15, 2019 (HealthDay News) — Expert guidance has been provided on the early detection of colorectal cancer and on treatment and posttreatment follow-up; the two guidelines were recently published online in the Journal of Global Oncology.
Gilberto Lopes, M.D., from the University of Miami, and colleagues identified and reviewed guidelines and used evidence from cost-effectiveness analyses to develop recommendations on the early detection of colorectal cancer. The authors recommend a guaiac fecal occult blood test and fecal immunochemical testing (basic), flexible sigmoidoscopy (add option in limited), and colonoscopy (add option in enhanced) for patients who are asymptomatic, aged 50 to 75 years, have no family history of colorectal cancer, are at average risk, and are in settings with high incidences of colorectal cancer. For persons with positive screens, the optimal reflex testing strategy is endoscopy or barium enema endoscopy is not available.
Ainhoa Costas-Chavarri, M.D., M.P.H., from Rwanda Military Hospital in Kigali, and colleagues reviewed guidelines and combined evidence to develop recommendations on the treatment and follow-up of early-stage colorectal cancer. The authors note that for nonmaximal settings, the recommended treatments for colon cancer stages nonobstructing I to IIA include open resection in basic and limited and laparoscopic or minimally invasive surgery with adequately trained surgeons in enhanced. For IIB to IIC, open en bloc resection following standard oncologic principles is recommended in basic and limited; if not possible, transfer to a high-level facility is recommended.
“ASCO believes that cancer and cancer prevention clinical trials are vital to inform medical decisions and improve cancer care and that all patients should have the opportunity to participate,” Costas-Chavarri and colleagues write.
Several authors from both sets of guidelines disclosed financial ties to the pharmaceutical industry.
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