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Colon Cancer Screening Recommendations from the American Gastro Association

March 01, 2015


Fecal Immunochemical Test receives a grade of "1B", just behind colonoscopy

Table 1. Grading recommendations

Grade of
recommendation/
description
Benefit vs. risk
and burdens
Methodological
quality of
supporting
evidence
Implications
1A/Strong
recommendation, high-quality evidence
Benefits clearly outweigh risk and burdens, or vice versa RCTs without important limitations or overwhelming evidence from observational studies Strong
recommendation,
can apply to
most patients
in most circumstances
without
reservation
1B/Strong
recommendation, moderatequality
evidence
Benefits clearly
outweigh risk
and burdens, or
vice versa
RCTs with
important limitations
(inconsistent
results,
methodological
fl aws, indirect,
or imprecise)
or exceptionally
strong evidence
from observational
studies
Strong
recommendation,
can apply to
most patients
in most circumstances
without
reservation
1C/Strong
recommendation,
low-quality
or very
low-quality
evidence
Benefits clearly
outweigh risk
and burdens, or
vice versa
Observational
studies or case
series
Strong
recommendation
but may change
when higher
quality evidence
becomes available
2A/Weak
recommendation,
high-quality
evidence
Benefits closely
balanced with
risks and burden
RCTs without
important
limitations or
overwhelming
evidence from
observational
studies
Weak
recommendation,
best action may
differ depending
on circumstances
or patients’ or
societal values
2B/Weak
recommendation,
moderate-quality
evidence
Benefits closely
balanced with
risks and burden
RCTs with
important limitations
(inconsistent
results,
methodological
flaws, indirect,
or imprecise)
or exceptionally
strong evidence
from observational
studies
Weak
recommendation,
best action may
differ depending
on circumstances
or patients’ or
societal values
2C/Weak
recommendation,
low-quality
or very
low-quality
evidence
Uncertainty in
the estimates of
benefits, risks,
and burden; benefits, risk, and
burden may be
closely balanced
Observational
studies or case
series
Very weak
recommendations;
other
alternatives
may be equally
reasonable