Using Risk Stratification to Select Colonoscopy or CT Colonography

Approximately 75 million people in the U.S. are considered to be at “average risk” for colorectal cancer and therefore are candidates for colonoscopy screening. However, the level of risk actually varies quite widely in this population, leading some investigators to propose targeting colonoscopy to patients at the higher end of the “average-risk” spectrum (e.g., older people) and using alternative screening methods in those at the lower end.

In this study, researchers developed a risk index to stratify average-risk patients (by age, sex, and family history) and then modeled the potential consequences of three screening strategies in these patients: universal colonoscopy, universal computed tomography colonography (CTC), and a stratified prot…