End of colonoscopies for cancer screenings?

New Canadian guidelines could change the way routine screenings are carried out for low-risk patients

Medical screenings are a common requirement among many health and life insurers: but now the way in which colorectal cancer is detected may be about to change.

The second most common cause of death from cancer among men, and the third most common among women, colorectal cancer had previously relied on an examination of the entire tract, known as a colonoscopy, for its detection. However, now the Canadian Task Force on Preventative Health Care has suggested a different approach among those who do not have a history of the disease in their family and who have no symptoms.

Instead, this low-risk group, aged 50-74, would be screened with fecal occult blood tests, which would be carried out every other year, along with a sigmoidoscopy, which would be carried out every 10 years. The latter involves a flexible scope being inserted to look at the lower area of both the rectum and colon, as opposed to the entire area which is covered in a colonoscopy.

Meanwhile, the task force suggests that patients aged 75 or more should not be screened as they have a lower life expectancy and there is not enough research into the potential benefits or harm of testing.

It must be noted, however, that these guidelines are not applicable for those who have the disease in their family history, nor will it apply to those deemed to have symptoms of the cancer.

According to Dr Maria Bacchus, who works for the University of Calgary as an internist, and who was the chairwoman of the working group which put the guidelines together, there is a “lack” of evidence about the efficacy of colonoscopies compared to flexible sigmoidoscopies.

During 2015 it was estimated that around 25,000 Canadians received a colorectal cancer diagnosis, with 9,300 dying as a result of the disease. The new guidelines are an update to 2001 research which recommended sigmoidoscopies every five years and fecal occult blood testing in one-two year intervals.

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