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J Am Coll Radiol. 2018 May;15(5S):S56-S68. doi: 10.1016/j.jacr.2018.03.014.

ACR Appropriateness Criteria® Colorectal Cancer Screening.

Author information

1
Principal Author, Emory University, Atlanta, Georgia. Electronic address: courtney.coursey@emoryhealthcare.org.
2
Co-author and Panel Chair, University of Wisconsin Hospital & Clinics, Madison, Wisconsin.
3
Global Advanced Imaging, PLLC, Little Rock, Arizona.
4
University of South Alabama, Mobile, Alabama; American Gastroenterological Association.
5
Newton-Wellesley Hospital, Newton, Massachusetts.
6
University of Texas MD Anderson Cancer Center, Houston, Texas; American College of Surgeons.
7
Mallinckrodt Institute of Radiology, Saint Louis, Missouri.
8
Virginia Tech Carilion School of Medicine, Roanoke, Virginia.
9
Massachusetts General Hospital, Boston, Massachusetts.
10
University of Virginia Health System, Charlottesville, Virginia.
11
Medstar Georgetown University Hospital, Washington, District of Columbia.
12
Duke University Medical Center, Durham, North Carolina.
13
Penn State Hershey Radiology, Hershey, Pennsylvania.
14
Lahey Hospital and Medical Center, Burlington, Massachusetts.
15
Beth Israel Deaconess Medical Center, Boston, Massachusetts.
16
University of California, San Francisco, San Francisco, California.
17
Specialty Chair, Virginia Commonwealth University Medical Center, Richmond, Virginia.

Abstract

This review summarizes the relevant literature regarding colorectal screening with imaging. For individuals at average or moderate risk for colorectal cancer, CT colonography is usually appropriate for colorectal cancer screening. After positive results on a fecal occult blood test or immunohistochemical test, CT colonography is usually appropriate for colorectal cancer detection. For individuals at high risk for colorectal cancer (eg, hereditary nonpolyposis colorectal cancer, ulcerative colitis, or Crohn colitis), optical colonoscopy is preferred because of its ability to obtain biopsies to detect dysplasia. After incomplete colonoscopy, CT colonography is usually appropriate for colorectal cancer screening for individuals at average, moderate, or high risk. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

KEYWORDS:

AUC; Appropriate Use Criteria; Appropriateness Criteria; Barium enema; CT colonography; Colorectal cancer; Colorectal cancer screening; MR colonography

PMID:
29724427
DOI:
10.1016/j.jacr.2018.03.014
[Indexed for MEDLINE]

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