Clinician's Roundtable

The NCCN Guidelines for Colorectal Cancer Screening recently provided updates for patients at average and increased risk—most notably, lowering the recommended starting age from 50 to 45. Hear Dr. Reid Ness walk through the updates in depth, providing insight on screening protocols for different patient populations. Dr. Ness is an Associate Professor of Medicine at Vanderbilt University Medical Center in Nashville, Tennessee, faculty with the Vanderbilt Ingram Cancer Center, and the Chairman of the committee that developed the colorectal cancer screening guidelines.

Colorectal cancer screening saw significant disruptions during the COVID-19 pandemic, a challenge that has also been reflected during natural disasters such as hurricanes and wildfires. Dr. Gloria Coronado joins Dr. Charles Turck to discuss how these kinds of crises impact screening rates and how a focus on community-based care, telehealth and home-based testing, and targeted efforts for underserved populations can strengthen resilience and ensure continuity of care during future disasters. Dr. Coronado is a Professor of Epidemiology and the Associate Director of Population Science for the University of Arizona Cancer Center in Tucson.

Colorectal cancer screening remains underutilized across several underserved populations, including racial minorities and rural communities. That’s why Dr. Charles Turck speaks with Drs. Jane McElroy, Jean Wang, and Nuha Wareg to learn about practical, evidence-based strategies we can implement to improve screening uptake, reduce disparities, and promote high-quality, equitable care. Dr. McElroy is a Professor in the University of Missouri’s Family and Community Medicine Department and the Co-Director of its Rural Health Research Center, Dr. Wang is a Professor of Medicine and Surgery in the Division of Gastroenterology at Washington University School of Medicine, and Dr. Wareg serves as a Practice Facilitator for the Missouri Partnership to Improve Colorectal Cancer Screening program at the University of Missouri.

Colorectal cancer screening saves lives—but how do common methods like colonoscopy and non-invasive screening methods compare in their environmental effects? With the healthcare sector being responsible for over four percent of the global carbon footprint, researchers are looking into more environmentally friendly options that can still provide optimal outcomes for patients. Dr. Peter Buch sits down with Dr. Mark Fendrick to examine the carbon footprint of available colorectal cancer screening strategies and explore how a shift to noninvasive options could offer promising clinical and environmental impacts. Dr. Fendrick is a Professor of Internal Medicine and Health Management and Policy at the University of Michigan.

Colorectal cancer screening strategies have significantly evolved in recent years, with noninvasive options like stool and blood-based tests explored for their potential to boost adherence. Drs. Gloria Coronado and Carolyn Rutter join Dr. Brian McDonough to evaluate how these methods compare to traditional colonoscopy in terms of cost-effectiveness, accessibility, and their ability to overcome screening barriers, particularly in underserved populations. Dr. Coronado is a Professor of Epidemiology and the Associate Director of Population Science for the University of Arizona Cancer Center, and Dr. Rutter is a Professor in the Biostatistics Program and Principal Investigator for a Cancer Intervention and Surveillance Modeling Network team at Fred Hutchinson Cancer Center.

From oncologists to primary care, physicians are witnessing an alarming trend in younger patients: the rising risk of colorectal cancer. To investigate this growing threat, Dr. John Russell speaks with Dr. Rich Wender, Chief Cancer Control Officer at the American Cancer Society. Dr. Wender discusses the new colorectal cancer screening guidelines set forth and the methods behind the conclusion. While comparing past guidelines, Dr. Wender considers changes in our society and environment that may be contributing to increased cancer risks in younger generations.

For more information and to review the new guidelines, go to cancer.org

The SMARTER CRC trial evaluated mailed fecal immunochemical (FIT) outreach and patient navigation strategies across rural clinics, analyzing how implementation factors like clinic-sent letters, consistent FIT usage, and active participation in health plan meetings impacted screening outcomes. Two authors of the study, Dr. Gloria Coronado and Dr. Amanda Petrik, join Dr. Charles Turck to discuss their findings and how these results may help guide effective, scalable screening interventions for underserved populations. Dr. Coronado is a Professor of Epidemiology and the Associate Director of Population Science for the University of Arizona Cancer Center in Tucson, and Dr. Petrik is an investigator at the Kaiser Permanente Center for Health Research in Portland, Oregon, where she focuses on cancer screening and prevention in real-world settings.

Timely colorectal cancer screening can mean the difference between prevention, cure, and advanced disease. Even delays as short as a year are associated with significantly increased risks of advanced cancer and mortality. Given this risk, Dr. Peter Buch speaks with Dr. Christopher Cann about the varying sensitives of available screening modalities, key patient barriers to adherence, and practical strategies to improve screening uptake. Dr. Cann is an Assistant Professor in the Department of Hematology Oncology at Fox Chase Cancer Center in Philadelphia, where he's also the Director of the Young Adult Cancer Program.

Colorectal cancer often develops without symptoms, making proactive screening essential for early detection and prevention. Tune in to hear Dr. Harish K. Gagneja, a board-certified gastroenterologist in Austin, Texas, explain how patient risk, test selection, and follow-up care influence smart and effective screening strategies.

Rural populations face unique challenges in accessing colorectal cancer screening, leaving many patients in these communities unscreened. However, mailed fecal immunochemical testing (FIT) may help address these barriers and improve adherence. Joining Dr. Peter Buch to discuss the benefits and limitations associated with FIT and its potential impact on the colorectal cancer screening landscape is Dr. Michael Dougherty. Dr. Dougherty is an Adjunct Assistant Professor in the Division of Gastroenterology and Hepatology at the University of North Carolina School of Medicine.