FCRC Beyond Blue Spring 2022 - Flipbook - Page 10
Cover STORY
HOT Topic
THE BEST
SCREENING
TEST
Have you ever heard the
saying, “The best colorectal
cancer screening test is the
one that gets done”?
It comes up often when you get around
people who are focused on getting others
screened. My mentor, Dennis Ahnen, MD,
used to say this a lot.
I was once a colonoscopy purist and
considered them the “the gold standard”
of screening when I began my work over
15 years ago. But over time. I’ve come
to see Dr. Ahnen’s side.
Without a doubt, a colonoscopy is the
only screening recommendation for those
who are at high or increased risk because
of personal or family history of colorectal
cancer. It is also the only screening
recommendation for those with a genetic
or hereditary condition, or those with
signs and symptoms of colorectal cancer.
But, throughout my career in colorectal
cancer screening, I’ve witnessed
true innovation. The variety of screening
options for people at average risk have only
increased and improved. When I started,
hardly anyone talked about or gave much
weight to the screening tests that weren’t
a colonoscopy. But now, noninvasive tests,
like stool-based DNA screening tests,
are detecting abnormalities with great
success rates. Tests that screen for
colorectal cancer using only blood and urine
are on the horizon. This is huge progress!
Dennis Ahnen, MD, (left) and, Andrea (Andi) Dwyer (right). Dr. Ahnen was Dwyer's mentor, and this article
is written in memory of him.
Currently, the United States Preventive
Services Task Force (USPSTF) and
the American Cancer Society (ACS)
recommend screening all adults ages
45 to 75 for colorectal cancer. Several
recommended screening tests are available.
Which is the best one? There’s a variety
of factors patients and their doctors must
consider. Here’s a few:
• Frequency (How often does the test
need to be performed?)
It’s going to take all the screening options
for us to reduce the number of colorectal
cancer deaths. Dr. Ahnen was right.
• Location (Where does the test
need to be performed?)
• Methods (Can the test be sent off to a lab,
or is a direct visual of the colon needed?)
• Bowel prep, anesthesia, or sedation
during the test (Can the patient tolerate?)
• Follow-up procedures for
abnormal findings
(What are potential next steps?)
• Age (Is the patient young and presenting
symptoms? Be aggressive. Is the patient
76 to 85 years old? Discuss overall health
status, prior screening history,
and preferences.)
Not every person can access or will
choose a colonoscopy as their initial test,
and a menu of FDA-approved options
(that are also covered by insurance)
now give patients decision-making power.
ANDREA (ANDI) DWYER
Program Director and Instructor at The Colorado School of Public Health and
University of Colorado Cancer Center; Advisor to Fight Colorectal Cancer’s
Research and Patient Education
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When it comes to the best
test, I have a new view:
“The best screening test
is the one that gets done…
and gets done well.”
Learn about all the screening
options and how often each test
needs to be done in our recently
updated Screening Mini Mag.
SCAN TO READ
In 8 years, colorectal cancer is
estimated to become the No. 1 cause of
cancer-related deaths for 20-49 year olds.
TO SAVE LIVES, WE MUST
FIGHT FOR MORE.
Join the Fight at FIGHTCRC.ORG
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