New colon screening recommendations offer choices

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WASHINGTON (Reuters) - New U.S. guidelines on checking people for colon cancer offer a range of choices, including so-called virtual colonoscopies and at-home tests.

By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) - New U.S. guidelines on checking people for colon cancer offer a range of choices, including so-called virtual colonoscopies and at-home tests.

The recommendations, released late on Wednesday, aim to encourage more Americans to get screened for colon cancer, the second leading cause of cancer death in the United States, with 148,810 cases and 49,960 deaths forecast for 2008.

They include the most strongly recommended test, a regular colonoscopy after age 50. This test, done with a small camera called an endoscope and under sedation, allows doctors to detect precancerous growths and remove them on the spot.

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But the guidelines also recognize that many people simply refuse to undergo such an invasive, uncomfortable and embarrassing procedure.

"It is the strong opinion of this expert panel that colon cancer prevention should be the primary goal of colorectal cancer screening," the guidelines read.

"Despite clear evidence that colorectal cancer screening saves lives and the existence of several effective tests, screening rates have lagged, costing thousands of lives every year," Dr. Otis Brawley, national chief medical officer of the American Cancer Society, said in a statement.

Brawley and colleagues said they hoped the new guidelines would encourage more people to get screened -- even though some of the tests detect cancer only after it has started, while others can completely prevent cancer.

These are the first joint recommendations from the American Cancer Society, the American College of Radiology, the American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy.

"We feel strongly that this will help consumers make decisions that can, quite literally, save their lives," said Dr. David Lieberman of the Portland Veterans Affairs Medical Center in Oregon, speaking for the gastroenterological groups.

People can opt for any of the following:

- Colonoscopy every 10 years

- Sigmoidoscopy, a less-invasive version, every 5 years

- Stool DNA testing

- Computed tomography colonography, also known as virtual colonoscopy

- Double contrast barium enema every 5 years

- Annual fecal occult blood test

- Annual fecal immunochemical test

The full guidelines are available on the Internet at (http://caonline.amcancersoc.org/).

"The addition of these new technologies can potentially encourage many more people to choose to be screened for colorectal cancer," said Dr. Arl Van Moore, chairman of the American College of Radiology Board of Chancellors.

Earlier on Wednesday, researchers reported in the New England Journal of medicine that the most dangerous types of pre-cancerous lesions in the colon could be flat growths that are easily missed by colonoscopies.

(Reporting by Maggie Fox; Editing by Eric Walsh)