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Cancer Care Issues - Advice From Dr. Cary Presant

Proper Frequency of Screening Colonoscopy in Our Patients: American or British?

Cary Presant, MD, Oncology, Hematology/Oncology, 12:07AM Dec 24, 2013

How often do we recommend repeat colonoscopy in our patients at risk of colon polyps or cancer? Do we just leave this to gastroenterologists and primary physicians, or do we make stronger recommendations to pour patents and our medical colleagues (e.g. at tumor boards)?


A publication by M. Martinez and coauthors (Ann Intern Med 2012; 157: 856) compared the impact of using British rather than American guidelines. In England, patients with >5 small (<1 cm) adenomas or 3 or more adenomas at least one >1cm are considered high risk, and repeat colonoscopy is recommended in 1 year. When following the U.K. guidelines, there was an increase of 19% in finding and removing new polyps. 



Since medical oncologists are frequently sennding our patients for colonoscopy following colon cancer care, It is important for us to be aware of this issue. More polyp removals means better prevention. With this recent publication in mind, I am now referring such patients with high risk colonoscopy results for earlier repeat procedure. 

Poll: When you follow your colon cancer patients, do you refer patients for their colonoscopy? 1. Yes, I follow them carefully.|2. No, I let the PCP handle repeat colonoscopy screening.|3. No, I let the gastroenterologist monitor this.|
About This Blog

Dr. Cary Presant describes research results, observations on oncology issues, and discussions on current cancer care topics that can help improve your quality oncology care and your oncology practice.

Disclosure: Cary A. Presant, MD, has disclosed the following relevant financial relationships:
Served as a director, officer, partner, employee, advisor, consultant or trustee for: Diatech Oncology; Digital Medical Network
Received research grant from: Diatech Oncology
Have a 5% or greater equity interest in: Diatech Oncology; Digital Medical Network
Received income in an amount equal to or greater than $250 from: Diatech Oncology
Served on the Board of Directors for: Medical Oncology Association of South California; Cancer Schmancer

  • Cary Presant

    Cary A. Presant, MD, FACP, a hematologist and medical oncologist, is a staff physician at Wilshire Oncology Medical Group. He has been director of cancer programs at Washington University School of Medicine, the Jewish Hospital of St. Louis, and the City of Hope National Medical Center in Los Angeles, California. He is currently Professor of Clinical Medicine at the University of Southern California School of Medicine. Dr. Presant's current research includes pharmacologic improvement of chemotherapy effectiveness by magnetic resonance spectroscopy, as well as the development of a new chemotherapy sensitivity test, based on apoptosis, for all types of cancer. He is the author of over 400 scientific articles in cancer treatment, cancer detection, chemotherapy, experimental tumor biology and pharmacology, liposomes for cancer diagnosis and therapy, magnetic resonance spectroscopy, measurement of quality of life in cancer patients, and quality care in oncology. As an author, Dr. Presant has written Navigating American Medicine, soon to be published, and is the physician columnist for the national patient Website Dr. Presant is past president of the California Division of the American Cancer Society, Chairman of the Board of Directors of the Medical Oncology Association of Southern California (MOASC), past Director of the American Society of Clinical Oncology (ASCO), and past president of the Association of Community Cancer Centers (ACCC).

The content of this blog does not necessarily reflect the viewpoints of Medscape.
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