Notice: NIH State-of-the-Science Conference: Enhancing Use and Quality of 
Colorectal Cancer Screening

Federal Register: January 15, 2010 (Volume 75, Number 10)            
                  Page 2552-2553

Agency:  DEPARTMENT OF HEALTH AND HUMAN SERVICES
         National Institutes of Health


    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 consensus@mail.nih.gov. 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]
BILLING CODE 4140-01-P