[Federal Register Volume 75, Number 10 (Friday, January 15, 2010)]
[Notices]
[Pages 2552-2553]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-666]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
NIH State-of-the-Science Conference: Enhancing Use and Quality of
Colorectal Cancer Screening
Notice is hereby given by the National Institutes of Health (NIH)
of the ``NIH State-of-the-Science Conference: Enhancing Use and Quality
of Colorectal Cancer Screening'' to be held February 2-4, 2010, in the
NIH Natcher Conference Center, 45 Center Drive, Bethesda, Maryland
20892. The conference will begin at 8:30 a.m. on February 2 and 3, and
at 9 a.m. on February 4, and will be open to the public.
Colorectal cancer is the second-leading cause of cancer-related
deaths in the United States. Approximately 50,000 people in the United
States are expected to die from colorectal cancer in 2009. Colonic
polyps, abnormal growths of tissue on the inner lining of the colon,
are relatively common findings in men and women 50 years and older.
Most of these growths are not cancerous, but one type of polyp, known
as an adenoma, can develop into colorectal cancer. Screening tests for
colorectal cancer generally either seek to identify and remove adenomas
or examine the stool for signs of early cancer in people who have no
symptoms. A range of colorectal cancer screening tests is available in
the United States. The U.S. Preventive Services Task Force currently
recommends that average-risk adults aged 50 to 75 years undergo
screening for colorectal cancer with annual fecal occult blood testing,
sigmoidoscopy (internal examination of the lower part of the large
intestine) every 5 years, or colonoscopy (internal examination of the
entire large intestine) every 10 years. Additional tests that may be
used for colorectal cancer screening include computed tomography (CT)
colonography and fecal DNA testing.
Although colorectal cancer is an important cause of mortality in
the United States, screening for this disease is currently
underutilized among eligible individuals. Despite evidence supporting
the value of screening, in 2005 only 50 percent of U.S. adults aged 50
and older had been screened according to guidelines. Rates of screening
for colorectal cancer are consistently lower than those for other
common cancers, particularly breast and cervical cancer. Reasons for
this disparity are complex. Unlike most other preventive services, in
colorectal cancer screening there are multiple test options from which
to choose, and patients and providers may have varying preferences for
or access to the tests. Successful completion of colorectal cancer
screening requires effort on the part of the patient to obtain stool
samples for testing or to clean the colon in preparation for endoscopic
examination. Test options may also differ in cost and availability for
a given community. Patient, provider, and healthcare system
characteristics may each play a unique role in influencing the use and
quality of colorectal cancer screening.
Adding to the complexity of this issue, colorectal cancer screening
may be overused or misused in certain situations. Despite uncertainty
regarding the benefit of removing small polyps, many people undergoing
sigmoidoscopy or colonoscopy have all identified growths removed. This
may put them at increased risk for possible complications from these
procedures, which can include rectal bleeding or colonic perforation (a
tear in the wall of the intestine that can cause a serious abdominal
infection). In addition, follow-up testing of individuals who have
previously had polyps removed may occur more frequently than available
evidence supports, which again may put people at risk for complications
and have both cost and
[[Page 2553]]
capacity implications for the healthcare system.
To provide healthcare providers, patients, policy makers, and the
general public with a comprehensive assessment of how colorectal cancer
screening and surveillance are most appropriately implemented,
monitored, and evaluated for average-risk populations in the United
States, the National Cancer Institute and the Office of Medical
Applications of Research of the National Institutes of Health will
convene a State-of-the-Science Conference February 2-4, 2010, to assess
the available scientific evidence related to the following questions:
What are the recent trends in the use and quality of
colorectal cancer screening?
What factors influence the use of colorectal cancer
screening?
Which strategies are effective in increasing the
appropriate use of colorectal cancer screening and follow-up?
What are the current and projected capacities to deliver
colorectal cancer screening and surveillance at the population level?
What are the effective approaches for monitoring the use
and quality of colorectal cancer screening?
What research is needed to make the most progress and have
the greatest public health impact in promoting the appropriate use of
colorectal cancer screening?
An impartial, independent panel will be charged with reviewing the
available published literature in advance of the conference, including
a systematic literature review commissioned through the Agency for
Healthcare Research and Quality. The first day and a half of the
conference will consist of presentations by expert researchers and
practitioners and open public discussions. On Thursday, February 4, the
panel will present a statement of its collective assessment of the
evidence to answer each of the questions above. The panel will also
hold a press telebriefing to address questions from the media. The
draft statement will be published online later that day, and the final
version will be released approximately six weeks later. The primary
sponsors of this meeting are the NIH National Cancer Institute and the
NIH Office of Medical Applications of Research.
Advance information about the conference and conference
registration materials may be obtained from the NIH Consensus
Development Program Information Center by calling 888-644-2667 or by
sending e-mail to [email protected]. The Information Center's
mailing address is P.O. Box 2577, Kensington, Maryland 20891.
Registration information is also available on the NIH Consensus
Development Program Web site at http://consensus.nih.gov.
Please Note: The NIH has instituted security measures to ensure
the safety of employees, guests, and property. All visitors must be
prepared to show a photo ID upon request. Visitors may be required
to pass through a metal detector and have bags, backpacks, or purses
inspected or x-rayed as they enter NIH buildings. For more
information about the security measures at NIH, please visit the Web
site at http://www.nih.gov/about/visitorsecurity.htm.
Dated: January 6, 2010.
Raynard S. Kington,
Deputy Director, National Institutes of Health.
[FR Doc. 2010-666 Filed 1-14-10; 8:45 am]
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