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Published online before print March 5, 2008
CA Cancer J Clin 2008; 58:130-160
doi: 10.3322/CA.2007.0018
© 2008 American Cancer Society
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Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008

A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology*,{dagger}

Bernard Levin, MD, David A. Lieberman, MD, Beth McFarland, MD, Robert A. Smith, PhD, Durado Brooks, MD, MPH, Kimberly S. Andrews, Chiranjeev Dash, MD, MPH, Francis M. Giardiello, MD, Seth Glick, MD, Theodore R. Levin, MD, Perry Pickhardt, MD, Douglas K. Rex, MD, Alan Thorson, MD, Sidney J. Winawer, MD on behalf of for the American Cancer Society Colorectal Cancer Advisory Group, the US Multi-Society Task Force, and the American College of Radiology Colon Cancer Committee

Dr. B. Levin is Professor Emeritus, The University of Texas MD Anderson Cancer Center, Houston, TX.
Dr. Lieberman is Chief, Division of Gastroenterology, Oregon Health and Science University, Portland Veterans Medical Center, Portland, OR.
Dr. McFarland is Adjunct Professor of Radiology, Washington University; St. Luke's Hospital and Center for Diagnostic Imaging, Chesterfield, MO.
Dr. Smith is Director, Cancer Screening, Cancer Control Science Department, American Cancer Society, Atlanta, GA.
Dr. Brooks is Director, Prostate and Colorectal Cancer, Cancer Control Science Department, American Cancer Society, Atlanta, GA.
Ms. Andrews is Research Associate, Cancer Control Science Department, American Cancer Society, Atlanta, GA.
Dr. Dash is Doctoral Candidate, Department of Epidemiology, Emory University, Rollins School of Public Health, Atlanta, GA.
Dr. Giardiello is John G. Rangos Sr. Professor of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Dr. Glick is Clinical Professor of Radiology, University of Pennsylvania Health System, Philadelphia, PA.
Dr. T. Levin is Staff Physician, Gastroenterology Department, Kaiser Permanente Walnut Creek Medical Center, Walnut Creek, CA.
Dr. Pickhardt is Associate Professor, Radiology Department, University of Wisconsin Hospital and Clinics, Madison, WI.
Dr. Rex is Professor of Medicine, Indiana University, Indianapolis, IN.
Dr. Thorson is Associate Professor of Surgery; and Program Director, Section of Colon and Rectal Surgery, Creighton University School of Medicine; and Clinical Associate Professor of Surgery, University of Nebraska College of Medicine, Omaha, NE.
Dr. Winawer is Attending Physician, Memorial Sloan-Kettering Cancer Center, New York, NY.

Disclosures: Workgroup members were asked to disclose relationships, including potential financial conflicts of interest. The following was disclosed: D. Lieberman served on the scientific advisory board for Exact Sciences, ending September 30, 2007. B. McFarland receives honoraria for serving on the medical advisory boards for Vital Images and Medicsight. P. Pickhardt serves as a paid consultant to Covidien, Viatronix, Fleet, Medicsight, and Philips. D. Rex receives an honorarium for serving as a speaker and research support for serving as an investigator for Olympus; serves on the scientific advisory board and receives research support for serving as an investigator for Given Imaging; and serves on the scientific advisory boards for Avantis, NeoGuide, G.I. View, and American BioOptics. M. Rodriguez-Bigas is on the speakers bureau of Genzyme. R. Wender serves on the scientific advisory boards for Epigenomics, GeneNews, and G.I. View, but receives no personal income for doing so. D. Johnson serves as an Exact Sciences clinical investigator, but has received no support since 2006. C. D. Johnson and Mayo Clinic have licensed a CT colonography software patent to GE Medical Systems.
Published online through CA First Look at http://CAonline.AmCancer.Soc.org.
To earn free CME credit for successfully completing the online quiz based on this article, go to http://CME.AmCancerSoc.org.

In the United States, colorectal cancer (CRC) is the third most common cancer diagnosed among men and women and the second leading cause of death from cancer. CRC largely can be prevented by the detection and removal of adenomatous polyps, and survival is significantly better when CRC is diagnosed while still localized. In 2006 to 2007, the American Cancer Society, the US Multi Society Task Force on Colorectal Cancer, and the American College of Radiology came together to develop consensus guidelines for the detection of adenomatous polyps and CRC in asymptomatic average-risk adults. In this update of each organization's guidelines, screening tests are grouped into those that primarily detect cancer early and those that can detect cancer early and also can detect adenomatous polyps, thus providing a greater potential for prevention through polypectomy. When possible, clinicians should make patients aware of the full range of screening options, but at a minimum they should be prepared to offer patients a choice between a screening test that is effective at both early cancer detection and cancer prevention through the detection and removal of polyps and a screening test that primarily is effective at early cancer detection. It is the strong opinion of these 3 organizations that colon cancer prevention should be the primary goal of screening.




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