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MIR-2007-5AB, May 2007
National Colorectal Cancer Awareness Month is Almost Over
Don’t Forget to Follow-Up!
National Colorectal Cancer Awareness Month is almost over, but that doesn’t mean the messages to your patients should stop until next year. Remind patients who have taken home a fecal occult blood test kit to use it. Follow up with patients on all screening results, even negative ones—everyone likes to hear good news. Remember, the appropriate follow-up for a positive fecal occult blood test result is a colonoscopy, not another fecal occult blood test.
Follow the Guidelines to Guide Next Steps When Polyps Are Found
A recent survey by the National Cancer Institute found that gastroenterologists and surgeons are performing surveillance colonoscopies at more frequent intervals than those recommended by evidence-based guidelines. For example, 24 percent of gastroenterologists and 54 percent of surgeons recommended a colonoscopy, either alone or with another procedure, at least every five years after the identification of a small, benign, hyperplastic polyp (Mysliwiec et al., 2004). Medical guidelines do not recommend any follow-up colonoscopy for hyperplastic polyps because their presence has not been shown to increase the risk of colorectal cancer. In contrast, adenomatous polyps ARE associated with cancer and people who have multiple polyps of this kind should be screened at shorter intervals.
Guidelines for surveillance after polypectomy were recently updated—here are references to two publications featuring these guidelines:
- Winawer, Zauber, Fletcher et al. Guidelines for Colonoscopy Surveillance after Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology 2006; 130:1872-1885.
- Winawer, Zauber, Fletcher et al. Guidelines for Colonoscopy Surveillance after Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. CA Cancer J Clin 2006; May-Jun; 56(3):143-59
For More Information
For specific details on Medicare coverage criteria and billing procedures for colorectal cancer screening services, refer to Special Edition MLN Matters article SE0710 at: http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0710.pdf  .
The Centers for Medicare & Medicaid Services (CMS) Web site also has a “ Prevention ” Web site, which contains a section on colorectal cancer screening. From the CMS home page, www.cms.hhs.gov  , select “Medicare” and scroll down to “Prevention” to find the colorectal cancer screening section.
Thank You for the Great Work!
Thank you for helping CMS spread the word regarding the importance of colorectal cancer screening. We are interested in knowing if the information we have provided over the last few weeks has been helpful, and if it has influenced your colorectal cancer screening practices. Please e-mail us at: Prevention@cms.hhs.gov.
Remember – Colorectal cancer is preventable, treatable, and beatable. Encourage your patients to get screened—it could save their lives.
CMS Learn Resource 200703-27
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