ACOG urges ob/gyns to advocate colorectal screening

A newly published opinion from the American College of Obstetricians and Gynecologists (ACOG) Committee on Gynecologic Practice encourages ob/gyns to recommend colorectal cancer screening to their patients, beginning at age 50, with repeat screenings every 10 years thereafter.

Colorectal cancer affects more women than all gynecologic cancers combined and is the third leading cause of cancer death after lung and breast cancer. More than 70,000 women are diagnosed with colorectal cancer each year in the United States, and more than 24,000 women die from their disease. Only 63% of US women over age 50 years who responded to a recent study had been screened by colonoscopy or sigmoidoscopy within the past 10 years or fecal occult blood test within the past year.

ACOG Committee Opinion No. 482 advises healthcare providers to counsel patients about the benefits of colorectal cancer screening and recommend colonoscopy because it allows thorough examination of the colon and rectum in 1 session, during which a biopsy or polypectomy also can be performed. The committee also advocates discussing the advantages and limitations of other appropriate screening methods with patients to allow them to choose “whichever method they are most likely to accept and complete.”

Tests that detect both adenomatous polyps and early colorectal cancer (ie, colonoscopy, flexible sigmoidoscopy, double contrast barium enema, computed tomography colonography) over tests that primarily detect cancer (ie, guaiac-based fecal occult blood test, fecal immunochemical test, stool DNA test) are recommended. In-office single stool guaiac fecal occult blood testing or digital rectal examination to screen for colorectal cancer are not recommended. Abnormalities found with screening methods other than colonoscopy require referral for diagnostic colonoscopy, the authors note.

The opinion has been published in Obstetrics and Gynecology (2011;117:766-771).