Jazmin A.

Payad Module 8 Lesson 4

BSN STEM 1H Critique Paper
The Joint Philippine Society of Gastroenterology (PSG) and Philippine Society of
Digestive Endoscopy (PSDE) Consensus Guidelines on the Management of
Colorectal Carcinoma

The Colorectal cancer or also known as CRC is a progressively rampant condition in

Asia, especially in the Philippines where its cases are rapidly increasing. In fact, it is the
most common gastrointestinal tract cancer in the country. Acknowledging the evidences
and cases, the Philippine Society of Gastroenterology (PSG), together with the
Philippine Society of Digestive Endoscopy or PSDE decided to perform a clinical
practice to formulate guidelines to provide evidence based endorsements which can
promote proper approach to manage the CRC that can lead to early detection,
appropriate treatment and adequate follow-up care of the said disease. The utilized
methods and the conditions are stated clear in the paper. The process of making the
manuscript was specified in a concise manner.

The statements mostly have a high level of evidence and is strongly recommended. The
first statement contains data not just from the Philippines but in other Asian countries as
well which is commended because it showed the rising trend of CRC in the continent. It
also showed that it is more well defined in economically advanced countries in contrast
with the poorer economies. The statement also exhibited the data from two population-
based registries of two populous places in the Philippines which showed a significant
upsurge in the ASRs or age-standardized incidence rates for colorectal cancers. These
evidences helped to prove and support the given statement. The statement 2 tackled
the factors which increase the risk of obtaining CRC. Every factor was thoroughly
discussed with corresponding data to analyze the effects of the factors to the risk. The
mentioned studies were conducted with a broad set of participants which is
commendable because it provides a wide understanding of different variables that can
have a substantial influence on the results. The statements 3,4 and 5 discussed the
early detection and screening for CRC for different age bracket. It shows that early
detection can increase the survival rate of the patient despite its long asymptomatic
phase. It is suggested that the CRC screening should start at 50-year-old but it must be
earlier for people who are high risk which are the patients with personal and/or family
history of polyposis syndromes because this significantly increase the risk of having
CRC. The statistical data supports the claim that early detection of CRC can strengthen
the chance of survival and recovery of the patients. The statement 6 endorses utilizing
fecal immunochemical test [FIT] as first line screening test in conducting fecal blood
tests because it’s a simple and non-invasive test. But the disadvantages in using this is
also stated which is good because it can help in balancing the pros and cons in using it
and it avoids biases. The statement 6 also provides an exemplary wide set varieties of
screening examinations that can be performed for patients. They also included the tests
that isn’t recommended to use as screening test. The other sets of statements
emphasize the appropriate approach and primary care for CRC patients.

In conclusion, the whole journal article contained a far reaching and extensive
recommendations which is backed up with large studies conducted with diverse
variables. It also indicates that CRC is common but the survival rate is high if it is
detected early. The article compiled all of these guidelines with the supporting
evidences and stated it in organized manner where people, especially the physicians
and other specialists can be informed and guided on how to treat the patients. The said
article also encourages them to be involved in public awareness of CRC prevention and
the importance of early screening. In this way, the cases of CRC will be reduced and
the mortality rate of it will drop. The medical professionals will be also able to improve
their treatment on the patients and help them on their recovery. Above all, it also
highlights the importance of accessible health care treatments such as the availability of
affordable and accurate tests which can promote early detection and treatment of CRC.