Making sense of the guidelines

Normal 0 false false false MicrosoftInternetExplorer4 st1\:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} The newer American bowel cancer screening guidelines are less relevant to the Australian health care environment and should not usurp the existing National Health and Medical Research Council (NHMRC) recommendations in Australia, experts say.   Writing in the MJA, gastroenterologists from Western Australia noted significant differences between the Australian recommendations endorsed by the NHMRC and two recently published American guidelines from the United States Preventive Services Task Force and from a collaboration of the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer.   “Interestingly, these guidelines differ due to differing interpretations of essentially the same evidence,” they noted.   The NHMRC guidelines strongly recommend screening from the age of 50 years by performing a faecal occult blood test at least every second year. The strength of this recommendation, they said, was based on strong evidence from three large, population-based, prospective randomised controlled trials demonstrating a mortality reduction of 15%–33%.   Flexible sigmoidoscopy performed five-yearly received an equivocal recommendation, whereas colonoscopy and computed tomographic colonography were not recommended because of insufficient evidence.   In the face of the various disparate guidelines a simple approach is to recommend participation in the nationwide population-based bowel cancer screening program, the authors advised.   Although the federal government had made no commitment to the NBCSP beyond June 2011, it was “inconceivable” that the program will simply be terminated, given the strong evidence basis for its function, they said. MJA 2009; 190 (7): 348-349...