Posted: October 12th, 2021

Condition and Screening

Please use the directions below and the attached rubric. I would like you to use either cervical cancer or colon cancer but please use whichever you feel most comfortable writing on. If you have any questions please reach out.
MN505M1-1: Interpret epidemiologic data on morbidity and mortality related to acute and chronic disease states.
Directions:
Individual Screening
Review the clinician provider guidelines and recommendations of the United States Preventive Services Task Force A and B Recommendations. https://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations/
For the MSN-prepared nurse, knowledge of epidemiology and its application to preventive screening guidelines is important in many clinical areas: administrative, education, and nurse practitioner fields. Consider you are working in a clinic and need to order a preventive screening on a patient for one of the conditions listed below. While this is a preventive measure, it also can be a diagnostic tool in other circumstances. For this assignment, the screening is a secondary prevention measure.
Please select one screening below. Your screening methodology must come from the United States Preventive Services Task Force guidelines.
Abdominal Aortic Aneurysm
Breast Cancer
Cervical Cancer
Colon Cancer
Diabetes Mellitus II
Lung Cancer
Condition and Screening
Identify and define the condition and type of screening. Screening choice is one from the assignment directions.
Epidemiology of Condition
Include a correct definition of the condition and defines the epidemiology of the condition in the United States through three statistical terms.
Include the correct mortality and related morbidity statistics in numerical format.
Address trends using terms such as increasing, larger, or less. Includes related disparities and population rate comparison (i.e., racial, sex, age, etc.)
Methodology
Incorporate USPSTF guideline development methodology process into the methodology section of the paper.
Discuss the population for the guideline using age, sex, or related characteristic, for the screening.
Include information on two risk factors addressed in the guideline methodology.
Justify the screening based on these risks using statistical rationale.
Explain and support measures of the screening.
Guideline
Provide a summation of the USPSTF guideline recommendation.
Include population characteristic/s, screening type, and interval.
Include most current recommendations.
Critical Analysis
Conduct a literature review of support used in the guideline. May include alternative studies found in more recent literature that supports or offers alternative views.
Cite four studies in the analysis.
Summary
Provide a summary conclusion of the screening guideline, general benefit to the individual and why it is important.
Format expectations:
Follows all assignment directions.
Introduction and conclusion are included.
Information in paragraphs and paper organized to convey the content to the reader.
Paper length paper should be 3–4 pages of content.
Follows APA in paper format, reference page, in-text citations, or headings.
Uses four or more credible peer-reviewed sources.

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Condition and Screening
The condition I will be discussing is colorectal cancer (CRC). CRC is the third leading cause of cancer death in the United States, after lung cancer and breast cancer. It is estimated that 106,120 people will be diagnosed with CRC and 50,610 people will die from the disease in 2023.

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The most common screening tests for CRC are fecal occult blood tests (FOBTs), flexible sigmoidoscopy, colonoscopy, and CT colonography (virtual colonoscopy). FOBTs are a simple and inexpensive test that can be done at home. Flexible sigmoidoscopy is a procedure that allows the doctor to view the rectum and sigmoid colon (the lower part of the colon). Colonoscopy is a procedure that allows the doctor to view the entire colon. CT colonography is a less invasive procedure than colonoscopy, but it is not as accurate.

The United States Preventive Services Task Force (USPSTF) recommends that adults at average risk of CRC begin screening at age 45. The USPSTF recommends FOBT every year, flexible sigmoidoscopy every 5 years, or colonoscopy every 10 years.

Epidemiology of Condition
CRC is a disease that affects the colon and rectum. It is caused by the growth of abnormal cells in the lining of the colon or rectum. These abnormal cells can form a tumor, which can grow and spread to other parts of the body.

The risk of developing CRC increases with age. The average age at diagnosis is 68. Other risk factors for CRC include family history, smoking, obesity, and a diet low in fiber and high in red meat.

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Methodology
The USPSTF uses a systematic review process to develop its recommendations. This process includes reviewing the scientific evidence on the benefits and harms of screening tests. The USPSTF also considers the costs of screening and the patient’s preferences.

In the case of CRC screening, the USPSTF found that there is moderate evidence that screening with FOBT, flexible sigmoidoscopy, or colonoscopy reduces the risk of death from CRC. The USPSTF also found that there is no evidence that screening with CT colonography reduces the risk of death from CRC.

Guideline
The USPSTF recommends that adults at average risk of CRC begin screening at age 45. The USPSTF recommends FOBT every year, flexible sigmoidoscopy every 5 years, or colonoscopy every 10 years.

Critical Analysis
The USPSTF’s recommendation for CRC screening is based on the evidence that screening reduces the risk of death from CRC. However, there are some limitations to the evidence. For example, the studies that showed a benefit from screening were conducted in the 1990s and early 2000s. It is possible that the benefit of screening is less today, due to changes in the way CRC is diagnosed and treated.

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Another limitation of the evidence is that it is not clear how long people should continue to be screened. The USPSTF recommends that people continue to be screened until they are 75 years old. However, some experts believe that people should continue to be screened for as long as they are at risk of developing CRC.

Summary
The USPSTF recommends that adults at average risk of CRC begin screening at age 45. The USPSTF recommends FOBT every year, flexible sigmoidoscopy every 5 years, or colonoscopy every 10 years.

The benefits of screening for CRC are clear. Screening can reduce the risk of death from CRC. However, there are some limitations to the evidence. It is not clear how long people should continue to be screened, and it is not clear if screening is as effective today as it was in the past.

Overall, the benefits of screening for CRC outweigh the risks. Screening can help to save lives.

References
American Cancer Society. (2023). Colorectal cancer facts & figures 2023. Atlanta, GA: American Cancer Society.
United States Preventive Services Task Force. (2021). Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. JAMA, 326(24), 2573-2585.

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