CAREWare Listserv and Colorectal Screenings
The CAREWare Listserv has been around for over a decade and routinely shows its mettle as a forum for concrete learning and problem solving. Take the July 12 question posed by Glenda Riley, the Ryan White Parts C/D Data Manager at Jefferson Comprehensive Care in Pine Bluff, Arkansas: "What are recommendations for colorectal screenings…how often, who receives them, and age range?"
That same afternoon, Laura Otten, HRSA Public Health Analyst in the HRSA Bureau of Primary Health Care, responded:
I’m an oncology nurse as well as a nurse informaticist. This is a very timely question as the American Cancer Society (ACS) recently changed their screening guidelines to begin average risk screening for all adults at age 45. They did so based on some studies that show that there is an increase in colorectal cancers in those under the age of 50. Many other sources disagree with this recommendation feeling that there is insufficient evidence to begin average risk screening before age 50 as the risks and any benefits of screening in this population have yet to be defined.
Generally we look to the Centers for Disease Control and Prevention (CDC) and U.S. Preventive Services Task Force (USPSTF) for evidence-based recommendations. These sources recommend screening for average risk persons begin at age 50.
For patients at increased risk all sources agree that earlier screening may be necessary. Both the CDC and the USPSTF also provide guidance as to who is high risk and when screening should begin for these persons. Here is a link to various screening methods and when and how to use them.
The National Comprehensive Cancer Network provides free access for registered users to a number of Guidelines including those for the “Detection, Prevention, and Risk Reduction” for several cancers including colorectal. There is no charge to register for an NCCN account. The NCCN also recommends average risk screening for colorectal cancer begin at age 50 and provides a workflow of who to screen, how to screen, and when to screen.
See the HRSA HIV/AIDS Bureau's Performance Measures on screening for cervical cancer, hepatitis, STDs, and other co-morbidities as well other health concerns for persons living with HIV