Q&A: Breast radiologist supports update to colorectal cancer screening guideline
The American Cancer Society (ACS) released an updated guideline Wednesday, May 30, that suggests people at regular risk begin colorectal cancer (CRC) screening at age 45, instead of the previously recommended age of 50.
Although recent developments in CRC screening have improved diagnosis, recent studies have shown a rise in colorectal cancer rates among younger populations—a primary reason for healthcare providers to support earlier screening.
Among them is Anjali Malik, MD, a breast radiologist at Washington Radiology serving patients in Washington, D.C. metro area. Health Imaging spoke with Malik about how the ACS's updated colon cancer screening guideline will impact diagnostic imaging and patient care.
Health Imaging: How will the ACS's updates impact diagnostic imaging? How is the guideline update relevant to your work, as a breast imaging and intervention radiologist?
Anjali Malik, MD: As one who often sees the devastating effects of advanced cancers, I am relieved for patients to have earlier access to lifesaving colon cancer screening technologies, such as optical and virtual colonoscopy (virtual CT).
As a breast imaging radiologist who works daily on early detection for breast cancer and as someone with a background in public health, I believe in finding effective tools for screening the population as a whole.
I support regular screening because evidence shows that early detection of treatable diseases is the best way to save the most lives. There are also syndromes that involve multi-organ malignancies, particularly breast and colon, and many of these patients are unaware of their genetic mutations until post-diagnosis. Earlier access for colon cancer screening may prompt early detection of breast cancer.
A recently published ACS study pointed to advancements in the decade since the last CRC guideline. What developments in CRC screening do you believe impacted this update?
The numbers always win—and population-based research has shown a need for earlier screening. Studies, including recent JAMA research, show that the mortality of colorectal cancer has slowly been increasing.
With an aging population and an obesity epidemic, we have many people at risk. Furthermore, a study published in the Journal of the National Cancer Institute showed that the more recent generations are at even higher risk for colon cancer.
In addition to the data on colon cancer, we have data on the efficacy of a plethora of screening tools. These options are needed to evaluate the large population. Accessibility plays a key role to effectively screening a large population.
The updated guideline suggests offering patients six different screening options. How will this help or hinder physicians and patients?
We live and practice in the age of precision medicine, which means individualized healthcare. One size does not fit all. For colon cancer screening, these six options mean patients and physicians will have a choice.
Additionally, one of the tenets of screening is accessibility, and having six options means six delivery vehicles for early detection, which is also important with the increasing numbers of those needing screening. Open dialogue between patients and physicians is needed to determine the best option for each individual.
You previously mentioned virtual CT. How could this technology improve screening?
Virtual CT is a quick, low-cost, low risk imaging option with minimal downtime that can be performed and interpreted in different locations. Unlike classic optical colonoscopy, no sedation is needed, so virtual CT colon cancer screening can be performed in the middle of a work day.
A recent graduate from Dominican University (IL) with a bachelor’s in journalism, Melissa joined TriMed’s Chicago team in 2017 covering all aspects of health imaging. She’s a fan of singing and playing guitar, elephants, a good cup of tea, and her golden retriever Cooper.