PodMed TT – Early Colorectal Cancer Screening

At what age should colorectal cancer screening begin? As Rick and I discuss on PodMed TT this week, new guidelines from the American Cancer Society have reduced the age from 50 to 45, driven by an observed increase in the number of cases of colorectal cancer among younger people.

Why is this happening? No one knows yet, but it seems prudent to begin screening earlier to catch these cases, since, as Rick observes in the podcast, colorectal cancer most often starts as polyps, which can be easily removed before they morph into cancer and spread.

Another noteworthy part of the new recommendations is that the society doesn’t recommend a specific test for screening. Instead, they recommend identifying the various stool-based and visualization methods and advising that patients be informed of the risks and benefits of each, then making a joint decision. The intervals for each form of screening vary, so that also needs to be factored into decision-making.

Other topics this week include fecal transplant as primary treatment for C. difficile infection in NEJM; giving a miss to chemotherapy for women with breast cancer at intermediate risk of recurrence, also in NEJM; and a look at whether attending physicians improve rates of medical errors if they attend rounds with trainees in JAMA Internal Medicine.

Until next week, y’all listen up and make healthy choices.