Together Again: Aromatase Inhibitor for DCIS and New Colorectal Cancer Screening Recommendations

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This week, Amol and Nathan discuss breast cancer and colorectal cancer:

Two randomized control trials compared the aromatase inhibitor anastrozole to tamoxifen as adjuvant hormone therapy for postmenopausal women with ductal carcinoma in situ. Both trials were double blind and multi-centred, with one trial (NSABP B-35) enrolling North American patients and the other (IBIS-II DCIS) enrolling patients from other countries. Both studies found that there was no difference in breast cancer recurrence in using anastrozole or tamoxifen.

The Canadian Task Force on Preventive Health Care authored new recommendations for colorectal cancer screening in primary care. The new guidelines recommend that in 50 to 74 year olds, fecal occult blood test (FOBT) or flexible sigmoidoscopy be used as the initial screening modality. Patients older than 75 years old should not be screened, and colonoscopy should not be used as the initial screening test. Nathan and Amol wonder how these new guidelines will translate to clinical practice.

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The Papers

1. IBIS-II DCIS: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)01129-0/abstract

2. NSABP B-35: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)01168-X/abstract

3. NSABP B-35 patient-reported outcomes: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)01169-1/abstract

4. Colorectal cancer screening guidelines: http://www.cmaj.ca/content/early/2016/02/22/cmaj.151125.full.pdf

Good Stuff

1. http://www.dailyherald.com/article/20160319/entlife/160318880/

2. http://montrealgazette.com/news/local-news/wounded-by-a-grenade-11-year-old-mykola-finds-hope-at-montreals-shriners-hospital

Music Credits (Creative Commons)

In your Robotic Heart – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/in-your-robotic-heart

Drive – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/drive-fresh-upbeat-pop-background-music

Vintage Dream – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/vintage-dream-loungejazzy-background-music

All tracks have been modified for the purposes of this podcast.

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