Going Against Medical Advice: PCPs’ Role in Reducing Colonoscopy Overuse

Radhakrishnan, Archana; Pollack, Craig Evan

doi:10.1007/s11606-014-3097-1

Cited by 1 publication

(1 citation statement)

References 8 publications

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“…Communication between endoscopists and PCPs around screening recommendations is important [10,35]. Endoscopists must navigate the balance between giving explicit recommendations to return in 10 years (which may be interpreted by the PCP as definitely needing to come back) and having patients and PCPs reassess the risks and benefits of repeat screening colonoscopy based on changes in interval health and even emerging data closer to the time when the next colonoscopy would be due.…”

Section: Discussionmentioning

confidence: 99%

Endoscopist Specialty Predicts the Likelihood of Recommending Cessation of Colorectal Cancer Screening in Older Adults

Calderwood

Anderson

Robinson

et al. 2018

American Journal of Gastroenterology

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VoLuME 113 | dEcEMBEr 2018 Background Colorectal cancer (CRC) is the second leading cause of cancer death in men and women in the United States (US). Because of the effectiveness of CRC screening in reducing the incidence of and mortality associated with CRC, ample research has focused on improving adherence to screening for CRC [1-3]. The "de-escalation" of screening, meaning the cessation of routine preventive screening in older adults when benefits may be minimal or outweighed by potential risks, is an emerging concept that will have increasing importance as the US population ages [4, 5]. Optimizing appropriate use of screening colonoscopy in older adults improves care at the patient level, and importantly, at the system level, it may reduce costs and improve availability of colonoscopy for those in need of first-time screening. In 2008, the US Preventive Services Task Force (USPSTF) recommended that routine CRC screening stops after the age of 75 and that the decision to screen be individualized between the ages of 76 and 85 [6]. At that time, the USPSTF also recommended against routine screening in adults over 85 years old. Similarly, the US Multi-Society Task Force (USMSTF) on CRC recommends that persons who are up-to-date with screening and have negative prior screening tests be considered to stop screening at the age of 75 years [7]. In addition, the USMSTF recommends

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Section: Discussionmentioning

confidence: 99%