To the Editor The updated USPSTF recommendation for colorectal cancer screening1 reflects a change in focus, providing a menu of screening choices without expressing a preference for any one option. Although we support patient choice and welcome efforts to improve participation in medical decisions, there are differences in the quality of evidence for these strategies. Reduction in mortality has been demonstrated for fecal occult blood testing and colonoscopy (as well as sigmoidoscopy) in randomized trials and large observational studies.1 In an evidence-based practice environment, these options should be preferred, and a tiered structure of the recommendations would have facilitated the communication of these demonstrated benefits.
Mergener K, Potter NT. Colorectal Cancer Screening Recommendations. JAMA. 2016;316(16):1716. doi:10.1001/jama.2016.14915