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Many disorders, especially malignancies, are asymptomatic in their early stages. Consequently, it is imperative that health care providers provide routine screenings so that diseases can be detected early on and prevention and treatment can be implemented if necessary. Screening is in no way a cure for diseases, but it provides a means to detect diseases before symptoms start. Screenings include Pap smear to detect cervical cancer, mammograms to detect breast cancer, colonoscopy to detect colorectal cancer, and low dose CT scan to detect lung cancer (Centers for Disease Control and Prevention (CDC), 2020).
Enacted in 1984, the U. S. Preventive Task Force (USPTF) is an independent group of experts from several specialties, such as pediatrics, primary care, behavioral health, and nursing, that strive to provide knowledge and advice on various interventions and preventive services for diseases based on evidence-based research (D’Andrea, Ahnen, Sussman, & Najafzadeh, 2019). The USPTF helps shape medicine by assisting health care professionals and patients to prevent and treat diseases. Patients and clinicians collectively decide what treatment is best for the patient based on the recommendation of “best practice” disseminated by the USPTF (D’ Andrea et al., 2019). The ultimate goal of USPFT is to promote and improve the health of Americans by enacting clinical preventive measures based on scientific research.
Colorectal Cancer Screening Recommendation
The USPFT has several recommendations in place regarding screening for colorectal cancer, which is a collective group of cancers that affects the large intestine (the colon) and/or the rectum. This type of cancer usually starts in the colon, preliminary as polyps in many cases, and then metastasize as cancerous cells to proximal areas of the gastrointestinal system or reproductive organs (American Cancer Society, 2020). According to the American Cancer Society, the recommendation for individuals of average risk of colorectal cancer is screening starting at age 45, with either a stool-based test that detects cancer cells in the stool or an imaging exam that visualizes the structures of the colon and rectum.
The American Cancer Society (2020) recommends that individuals who are in “good health and a life expectancy of at least 10 years” should continue to be screened for colorectal cancer until they are 75 years of age. For individuals 76 to 85 years of age, the choice to continue to be screened should be based on the preference of the patient, their life expectancy, overall health status, and outcome of prior screenings (American Cancer Society, 2020). Screening is not recommended for individuals over the age of 85 due to their decreased life expectancy with or without the disease (American Cancer Society, 2020).
The American Cancer Society (2020) reports that testing for colorectal is separated by stool-based testing or visualization of images. The stool-based tests include a highly sensitive fecal immunochemical test (FIT) perform annually, a highly sensitive guaiac-based fecal occult blood test (gFOBT) perform annually, or a multi-targeted stool DNA test (mt-sDNA) done every 3 years (American Cancer Society, 2020). The American Cancer Society (2020) further elaborates that imaging tests include a flexible sigmoidoscopy (FSIG) performed every 5 years, a CT colonography commonly called a virtual colonoscopy every 5 years, and a colonoscopy every 10 years. A CT colonography is a virtual colonoscopy in which the individual swallows an encapsulated camera so that the practitioner can view structures of the GI system and colon. A double-contrast barium enema might be suggested for individuals unable to tolerate a colonoscopy, even though the ability to detect cancerous cells is not as clear as it is with colonoscopy. Individuals that have a greater than average risks, such as those with a strong family history of colorectal cancer, personal history of prior colorectal cancer, prior history of abdominal radiation, history of polyps, family history of Lynch Syndrome, or history of IBD, should be tested earlier than 45 and more often than what is recommended for an individual of average risk (American Cancer Society, 2020).
The American Cancer Society (2020) proclaims that colorectal is the 3rd leading cause of cancer-related deaths. As a result, close adherence to the guideline about colorectal cancer should be followed to improve life expectancy, decrease the likelihood of metastasis, and ameliorate complications from the disease. Initiation of treatment in a prompt manner will aid in facilitating better patient outcomes and improving individual prognoses.
U.S Preventive Task Force
The U.S preventive task force (USPTF) is a self-governing volunteer panel of global specialists in evidence-based medicine and disease prevention. Its main work is to improve all Americas' health standards by making evidence-based recommendations on clinical preventive services.
Colon cancer also referred to as colorectal cancer mainly affects the colon and the rectal. Finding out about colon cancer at an early stage is very advantageous. That is why a specific screening test can be carried out for people with no signs of cancer to help identify the cancer signs at an early stage. Doctors have highly recommended that at the age of 50- 75 years, people with an average risk of contracting colon cancer should begin screening (Howren et al., 2021). However, people with increased risk, such as African-American heritage or those with a family history of colon cancer, are advised to start their screening earlier. USPSTF makes recommendations that adults aged 76 to 85 should inquire from their doctors on whether to get screened for the disease. That approval is healthy because colonoscopy is used during the screening process, and polyps' removal is easy before it grows to actual cancer.
Some of the recommended tools for early cancer screening include sigmoidoscopy that uses a light tube inserted in the lower colon and the rectum to identify cancer, polyps, and any other abnormalities (Kerrison et al., 2021). The other tool used is computed tomography Colonography (CT or CAT), a recently studied tool that requires an expert radiologist to get accurate results (Bryce & Bucaj, 2021). The other device is the Double-contrast barium enema (DCBE). This is used on those patients who cannot undergo colonoscopy. It helps the rectum and the colon stand out during the x-ray, which allows the x-rays of the rectum and colon to get taken fast and efficiently. However, this tool is less effective in detecting precancerous polyp when compared to the other tools.
Those work are base in the following questions:
1.) What is the U.S. Preventive Task Force (USPTF)?
2. ) Select a disease for example colon cancer and discuss the screening age recommendations and the screening tools recommended for early prevention?