Last updated on Jul 7th, 2020 at 02:09 pm

You’ve probably heard that everyone over 50 needs a colonoscopy, but now experts are advising against routine bowel cancer testing…

According to a panel of international experts, a colonoscopy – one of the routine tests for bowel cancer – should not be recommended for everyone aged 50-79 years.

They say that for those at very low risk, the benefit is small and uncertain and there are potential harms.

However, they do advise screening for anyone with a risk of three percent or more in the next 15 years, as this is the point at which the balance of benefits and harms tilts in favour of screening.

Bowel (colorectal) cancer is a common type of cancer in men and women – about 1 in 20 people in most high-income countries will get it during their lifetime.

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Most guidelines recommend screening for everyone from age 50, irrespective of their individual risk.

At this age, the risk of developing bowel cancer over the next 15 years is typically one to two percent, meaning that in a group of 100 people with the same risk factors, one or two will develop bowel cancer within the next 15 years.

The most common forms of bowel cancer screening

The most common screening options are:

  • Home faecal testing (FIT) every year or every two years
  • Sigmoidoscopy (examination of the lower colon)
  • Colonoscopy (examination of the entire colon) done at a clinic or hospital

Screening can reduce bowel cancer deaths by 45%

Choose how you would prefer to be screened

The international panel made up of researchers, clinicians and patients, evaluated the benefit-to-harm balance of screening using a “risk-based approach”.

For men and women with an estimated 15-year bowel cancer risk below three percent, they suggest no screening and say most informed individuals in this group are likely to decline screening.

However, for men and women with an estimated 15-year bowel cancer risk above three percent, they suggest screening with one of the options after discussing the potential benefits and harms with their doctor.

The panel does not recommend any test over another.

Some people will want to avoid an invasive test like a colonoscopy, and may prefer faecal testing, while those wanting to avoid repeated testing may be likely to choose sigmoidoscopy or colonoscopy.

Signs of colorectal cancer in women

Source: BMJ via

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