Special ReportCystic Fibrosis Colorectal Cancer Screening Consensus Recommendations
Section snippets
Methodology
The CRC screening task force convened in April 2015 at the CF Foundation Headquarters. The 18-member task force consisted of pulmonologists, gastroenterologists, a social worker, nurse coordinator, surgeon, epidemiologist, statistician, adult with CF, and a parent of a child with CF. The committee was divided into 3 workgroups: Cancer Risk, Transplant, and Procedure and Preparation.
At the initial meeting, the task force determined the scope of the document; developed (PICO) Population,
Results
The task force found limited information on CRC screening in adults with CF, and available reports consisted mostly of retrospective reviews of patient records and case−control studies. The task force identified no randomized clinical trials comparing results in screened vs nonscreened patients or reports comparing results of colonoscopy with results of less-invasive screening procedures.
The task force developed ten recommendations (Table 1). Based on the quality and limited number of studies,
Conclusions
The CF CRC screening task force recommends screening with colonoscopy beginning at age 40 years for non-transplanted patients with CF and age 30 years for persons who have undergone and successfully recovered from a transplantation procedure. All decisions around CRC screening should be made in concert with the adult with CF. These discussions should include the consideration of comorbidities, safety, treatments, and quality of life. These recommendations are similar to the guidelines for
Raising Awareness of Colorectal Cancer Risk and Acceptability of Screening
Because of the absence of any information on other screening procedures, the task force recommends colonoscopy screening as the current best screening procedure. Thus, a key issue is acceptability of this procedure by the CF community. One member of the task force contacted several CF care centers and found a high degree of compliance when colonoscopy was recommended, with level of patient education on bowel preparations being a key factor for acceptance. Because many patients and center
Acknowledgments
Cystic Fibrosis Colorectal Cancer Screening Task Force: Amy Leigh Braid, Community Advisor to the Cystic Fibrosis Foundation; Joanne Cullina, MSN, APN, ACNS-B, Northwestern University; Anne Daggett, MSW, LCSW, St. Luke’s Cystic Fibrosis Center of Idaho; Aliza Fink, DSc, Medical Department, Cystic Fibrosis Foundation; Andrea Gini, MSc, Department of Public Health Erasmus MC, Rotterdam, The Netherlands; Denis Hadjiliadis, MD, MHS, Paul F Harron Jr Associate Professor of Medicine Perelman School
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Conflicts of interest The authors disclose no conflicts.