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Medicine Grand Rounds - Screening and Surveillance for Colorectal Cancer

In this presentation, Dr. Rex describes the molecular basis for different types of precancerous polyps and the differences between conventional or traditional, and serrated adenomas. The degree of risk and the pathogenesis for development of colorectal cancer is dependent on the identification of the histology of the polyp(s). Dr. Rex discusses the pros and cons of available screening tests including FIT, Cologuard, fecal DNA, and colonoscopy, as well as the changing epidemiology of colon cancer as this informs the type of test patients should pursue. Based on risk stratification, Dr. Rex identifies surveillance intervals for patients with or without a history of colon cancer and helpful hints for primary care physicians for how to effectively meet screening recommendations.

Activity Details

Start Date: December 7, 2018
End Date: December 7, 2020

You may claim CME credit for successful completion of this online course. In order to claim credit, you must follow these steps:

  1. Register for the learning activity by creating an account or logging in to your account.
  2. Click Continue to navigate to the Activity Material tab. Click View Presentation to view the recording.
  3. Return to this Activity page.
  4. Click Continue to navigate to the Evaluation tab; then click the Launch button to start the evaluation.
  5. Complete and Submit the evaluation and attestation form.

When the evaluation is submitted, you will be awarded credit. You may access your transcript for verification of participation at any time via Your Account. Need help? Visit the Support Page, send an Email, or call the Center for Learning and Professional Development at (603) 653-1234, Option 1.

  • Douglas K. Rex, MD, MACP, MACG, FASGE, AGAF
    Distinguished Professor of Medicine
    Indiana University School of Medicine
    Indiana University-Purdue University Indianapolis 

    Dr. Douglas K. Rex is a Distinguished Professor of Medicine at Indiana University School of Medicine, and at Purdue University Indianapolis, and Director of Endoscopy at Indiana University Hospital in Indianapolis.  He graduated from Harvard College, Summa Cum Laude in 1976 and with highest distinction from Indiana University School of Medicine in 1980.  He received the Outstanding Teacher Award in the Introduction to Medicine course five times and has been awarded the Indiana University School of Medicine Outstanding Teacher Award as well as Department of Medicine’s Excellence in Teaching Award.  He is a full-time clinical gastroenterologist at Indiana University Hospital. 

    Dr. Rex’s major research interests have been in colorectal disease and, in particular, colorectal cancer screening and the technical performance of colonoscopy.  He co-authored the colorectal cancer screening recommendations of the American College of Gastroenterology and the U.S. Multi-Society Task Force on Colorectal Cancer.  He also authored the recommendations on quality in colonoscopy of the U.S. Multi-Society Task Force on Colorectal Cancer and the American College of Gastroenterology/American Society of Gastrointestinal Endoscopy.
Learning Outcome

At the conclusion of this activity, participants will be able to recognize the pros and cons of available colorectal screening tests, discuss recommendations for screening in persons with a family history of colorectal cancer or polyps, and review standard post-polypectomy surveillance intervals.


Dartmouth-Hitchcock is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Dartmouth-Hitchcock designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Requirements for Successful Completion

In order to receive credit for this Continuing Medical Education (CME) activity, you must:

  • View the entire presentation
  • Complete the online Attestation of Attendance & Evaluation Form (you must register to access).

In accordance with the disclosure policy of Dartmouth-Hitchcock/Geisel School of Medicine at Dartmouth as well as standards set forth by the Accreditation Council on Continuing Medical Education and the Nursing Continuing Education Council standards set forth by the American Nurses Credentialing Center Commission on Accreditation, continuing medical education and nursing education activity director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content have been asked to disclose any financial relationship* they have to a commercial interest (any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on patients). Such disclosure is not intended to suggest or condone bias in any presentation, but is elicited to provide participants with information that might be of potential importance to their evaluation of a given activity.

The following Activity Physician Director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content for Screening and Surveillance for Colorectal Cancer (Medicine Grand Rounds) have reported the following financial interest or relationship* with various companies/organizations. The Activity Director and Planning Committee member roles were resolved by altering the individual’s control over content about the products or services of the commercial interest by the Associate Dean for CME and the Department of Medicine Chair. All potential conflict(s) were resolved.

* Kelly Kieffer, MD ~ her spouse is a consultant for OcculoBio. 

* Richard I. Rothstein, MD ~ has research support from Baranova (research grant to Dartmouth-Hitchcock Medical Center) and has other financial interest from Takeda. 

* Douglas K. Rex, MD ~ is a consultant with Aries Pharmaceutical, Cosmo Pharmaceutical, is a consultant and has research support from Boston Scientific, Olympus Corp, Braintree, and has research support from Sebela, Medtronic, EndoAid Ltd, Paion, and Medivators.

Other planning committee member(s), speaker(s), activity director(s), author(s) or anyone in a position to control the content for this program report no financial interest or relationship* with any company(ies) or organizations whose product may be germane to the content of their presentations.

*A “financial interest or relationship" refers to an equity position, receipt of royalties, consultantship, funding by a research grant, receiving honoraria for educational services elsewhere, or to any other relationship to a company that provides sufficient reason for disclosure, in keeping with the spirit of the stated policy.

Provider Contact Information

Provider contact information for questions regarding accreditation of the activity:

Center for Learning and Professional Development
Dartmouth-Hitchcock Medical Center

Type:     Internet Activity (Enduring Material)
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