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Preventing colon cancer: the problem with guidelines or The perils of prevention
Author(s) -
Ward Michael
Publication year - 1997
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1997.tb140076.x
Subject(s) - dilemma , medicine , variety (cybernetics) , colorectal cancer , alternative medicine , clinical practice , interpretation (philosophy) , face (sociological concept) , engineering ethics , medical education , family medicine , cancer , pathology , computer science , sociology , social science , philosophy , epistemology , artificial intelligence , engineering , programming language
Recent years have seen the publication of clinical guidelines that define professional consensus for the management of a variety of disorders; applying these guidelines in practice is not always easy. This problem is exemplified by the recent recommendations, jointly endorsed by the Australian Gastroenterology Institute (AGI) and the Australian Cancer Society (ACS), for screening and surveillance for colorectal cancer. 1,2 The guidelines are, for the most part, useful and well‐reasoned, but the recommendations for populations with an average and low (family‐history) risk for colorectal cancer raise difficulties in both interpretation and implementation. Such difficulties probably reflect the dilemma that all reference working parties for guidelines face in trying to accommodate diverse opinions. The AGI guidelines for colorectal cancer recommend that an informed discussion be undertaken with each patient on all the options, and that screening advice should be tailored accordingly. Fully informed discussion is often a challenging exercise, and it is interesting to speculate on how such a dialogue might unfold. Perhaps it could be something like this …