The American College of Obstetricians and Gynecologists (ACOG) has released a committee opinion encouraging obstetrician-gynecologists to recommend colorectal cancer screening for women, which is diagnosed in more women than all gynecologic cancers combined. The report points to colonoscopy as the recommended procedure but suggests other satisfactory alternatives.
Each year in the United States alone, more than 70,000 women are diagnosed with colorectal cancer, and more than 24,000 women die of the disease. It is the third leading cause of cancer death in women, after lung cancer and breast cancer.
There is a consensus among healthcare organizations that screening can reduce these numbers, primarily by reducing the incidence of advanced disease by detecting early-stage adenocarcinomas and removing adenomatous polyps. Prospective randomized trials have confirmed this benefit, showing reductions in mortality rates associated with early detection of colorectal and removal of polyps.
Despite these benefits, a recent study of women 50 years and older in the United States reported that only 63% had undergone colonoscopy or sigmoidoscopy in the past 10 years or a fecal occult blood test within the past year. Screens remain underused in many population segments, and in other cases they are inappropriately ordered for patients younger than 50 years or are ordered at too frequent intervals.
ACOG recommends colonoscopy for colorectal cancer screening among average-risk women at age 50 years. And, the report provides a review of available screening methods suitable for obstetrician-gynecologists to discuss with their patients.
J. Kyle Mathews, MD
Plano OBGyn Associates
Plano Urogynecology Associates