AHCPR Issues Colorectal Cancer Screening Evidence Report

ROCKVILLE, Md--In the first report issued under its new Evidence-basedPractice Initiative, the Agency for Health Care Policy and Research (AHCPR)has reaffirmed that early detection and treatment provide the primary meansof preventing death from colorectal cancer.

Among the conclusions of the report, based on a review of 3,500 citationsfrom the scientific literature (1966 to 1994):

• Use of fecal occult blood testing followed by diagnostic evaluationand treatment for positive tests can cut colorectal cancer mortality by15% to 33%.
• A 60-cm flexible sigmoidoscopy identifies nearly all cancers and polypsgreater than 1 cm in diameter and 75% to 80% of small polyps.
• Sigmoidoscopy screening can reduce colorectal cancer mortality riskby 59% to 80%.
• Indirect evidence supports the use of double-contrast barium enemain screening for colorectal cancer.
• While screening colonoscopy offers the potential to both identify andremove cancers and premalignant lesions, no studies completed to date showan associated mortality reduction.
• Detecting and removing polyps reduces the incidence of colorectal cancer,and removing early cancers lowers mortality. Although both double-contrastbarium enema and colonoscopy detect polyps and tumors, they have not beenstudied as screening tests.

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