News & Events

Category: News

American Cancer Society Updates Colorectal Cancer Screening Guideline

May 31, 2018

A new American Cancer Society guideline says colorectal cancer screening, like colonoscopy, should now begin at age 45 – five years younger than previously recommended – for all individuals. Age 50 was the long-held standard age for adults to begin colorectal cancer screening. This new recommendation, to lower the age by five years, is based on data showing rates of colorectal cancer are increasing in young and middle-aged populations.

The updated screening guideline recommendation is based on colorectal cancer incidence rates, results from modeling that demonstrated a favorable benefit-to-burden balance of screening beginning at age 45, and the expectation that screening will perform similarly in adults ages 45 to 49 as it does in adults 50 and over.

The American Cancer Society now recommends:

  • Adults ages 45 and older to begin regular colorectal screening.
  • As a part of the screening process, all positive results on non-colonoscopy screening tests should be followed up with timely colonoscopy.
  • Adults in good health with a life expectancy of greater than 10 years should continue colorectal cancer screening through age 75. Clinicians should individualize colorectal cancer screening decisions for individuals ages 76 through 85, based on patient preferences, life expectancy, health status, and prior screening history. Clinicians should discourage individuals over age 85 from continuing colorectal cancer screening.

According to the American Cancer Society, colorectal cancer incidence has declined steadily over the past two decades in people 55 and over primarily due to increased colonoscopy screening that results in removal of polyps, as well as changes in exposure to risk factors.

“It is important to note that there are multiple options for someone to be screened for colon cancer, but patients should be informed that colonoscopy is still the gold standard and the procedure by which all others are measured,” says Dr. Jayant Talreja, a gastroenterologist with Richmond-based Gastrointestinal Specialists, Inc. “With colonoscopy, if an abnormality is found, the added benefit is that a therapeutic intervention can be performed during the procedure. If precancerous polyps are found, they can be removed. In the unfortunate scenario of a cancer, it can be biopsied. Colonoscopy has been very effective in bringing about the decline of colorectal cancer and related deaths in the over 50 population. If alternative screening tests are found to be abnormal, then a colonoscopy will generally still be required.”

However, according to the American Cancer Society, there has been a 51% increase in colorectal cancer among those under age 50 since 1994. Death rates in this age group have also begun to rise in recent years. A recent analysis found that adults born around 1990 have twice the risk of colon cancer and four times the risk of rectal cancer compared with adults born around 1950, who have the lowest risk.

“In my five years of practice, I have anecdotally seen a rise in the incidence of colon cancer in the younger population and that observation has been supported by the experiences of my colleagues,” says Talreja. “In many of these cases, patients may not have a typical presentation of symptoms and in some cases, the patients had no symptoms. The underlying cause could only be detected with colonoscopy.”

While the colorectal cancer incidence rate among adults 45 to 49 is lower than it is among adults 50 to 54, the higher rate in the 50-54 age group is partially influenced by the uptake of screening at age 50, which leads to an increase in the incidence rate due to detection of prevalent cancers before symptoms arise. Since adults in their 40s are far less likely to be screened than those in their 50s, the true underlying risk in adults aged 45-49 years is likely closer to the risk in adults ages 50 to 54 than the most recent age-specific rates would suggest. Importantly, studies by the American Cancer Society suggest the younger age cohorts will continue to carry the elevated risk forward with them as they age.

“Lowering the age to begin screenings is expected to benefit not only the segments of the population who suffer disproportionately from colorectal cancer – African-Americans, American Indians and natives of Alaska – but also all individuals considered to be at an average risk… which really is, everyone,” says Talreja. “We believe this
recommendation by the American Cancer Society is very positive, the correct decision and will likely save many lives.”

About Gastrointestinal Specialists, Inc.

Gastrointestinal Specialists, Inc. (GSI) is a group of 18 board-certified gastroenterologists and ten nurse practitioners/physician assistants who have been providing comprehensive GI care for more than 30 years throughout the Greater Richmond area treating the entire spectrum of gastrointestinal and liver diseases. GSI has four primary offices in the Richmond region and sees patients at all area hospitals. Procedures are performed at two conveniently located and fully accredited endoscopy centers, allowing for fast, easy access to routine diagnostic and therapeutic procedures.

Supporting documentation

Article: American Cancer Society Updates Colorectal Cancer Screening Guideline;

Article: Colorectal Cancer Screening for Average-Risk Adults: 2018 Guideline Update from the American Cancer Society; CA: A Cancer J for Clin doi: 10.3322/caac.21457. Lead author Andrew M. D. Wolf, M.D., Chair of the Committee Subgroup for CRC Guideline Update.

Kelley Osborne: Welcome to the GSI Team

November 1, 2017

We would like to take a moment and welcome our newest nurse practitioner, Kelley Osborne. Kelley Osborne is ANCC board certified family nurse practitioner, as well as an ASMBS certified bariatric nurse and works at our Wadsworth office, primarily with Dr. Omer Khalid.

She received her bachelor’s degree in liberal arts from Virginia Tech and originally worked at GSI as a front desk and medical assistant; an experience that led her to seek her advanced nursing degrees. After graduating nursing school in Boston, she spent three years working as a nurse practitioner in the Gastrointestinal Surgery Department at Hospital of University of Pennsylvania and then three years as director for the Sibley Center for Weight Loss Surgery in Washington, D.C.

She was born and raised in Richmond and is excited to be with the practice. Happily married, she is the busy mother of three young children who enjoys gardening and reading in her free time.

Dr. Talreja and Dr. Thanjan Work with HCB2 to Help Provide A Day of Free Colonoscopies

July 7, 2015

Here at Gastrointestinal Specialists, we like to acknowledge when our staff goes above and beyond to make a difference in patients’ lives and in our community. On Saturday, June 13th, our very own Dr. Talreja and Dr. Thanjan participated in providing a day of free colonoscopies to the uninsured in the Richmond community. In just 8 hours, they were able to see a total of 21 patients, 45% of which had polyps that needed to be removed.

Dr. Andy J. Thanjan

Dr. Andy J. Thanjan

Dr. Jayant P. Talreja

Dr. Jayant P. Talreja










This great event was made possible by HCB2 and their collaboration with Access Now. Access Now helps provide the 22 free medical clinics in the Richmond area with the services and resources they need to help save lives.

Is It Time For Your Colonoscopy Screening Test? 

If you’ve never had a colonoscopy and you’re over the age of 50, have a family history of colon cancer, or if you’re considered to have a high risk of colon cancer, our doctors recommend you come in for a screening as soon as possible. Or, if you’re experiencing any of the following symptoms, we highly recommend you come visit us for a colonoscopy as soon as you can.

Symptoms of colon cancer commonly include:

  • Blood in your stool
  • Frequent and unexplained pain, cramps, and aches in your stomach
  • A change in your bowel habits
  • Constipation or diarrhea that’s unrelated to your recent meals
  • Unexplained weight loss

These symptoms can be caused by something other than colon cancer, but the only way to definitively know is by seeing a doctor. Make your appointment today!

Congrats to our retiring physicians

November 4, 2013

GSI announces the retirement of two of our physicians on November 27, 2013 – Dr. Louis G. Gelrud and Dr. Paul S. Monroe.  Although they will be sorely missed at the practice, we are pleased that they will have the chance to relax and enjoy after working so very hard for such a long time.


“I feel that I have been privileged to care for you during the time that we shared a physician-patient relationship, and I want to thank you for your confidence in me.” – Dr. Gelrud




Monroe“My sincere thanks for the trust and confidence you have shown in me.  I am proud to have helped you with your GI care.” – Dr. Monroe



If you are a patient of either Dr. Gelud or Dr. Monroe, we will be happy to transfer your care to any of the partners in the group, or, if needed, we will gladly forward copies of your medical record to the provider of your choosing.

Join us in offering congratulations to Dr. Gelrud and Dr. Monroe and in wishing them a Happy Retirement!

GSI is Patient Centered

October 24, 2013

Gastrointestinal Specialists has made a commitment to develop more compassionate care practices and to publicly proclaim to patients and communities our commitment to patient centered care.

At GSI, we are firm believers in patient-centered care. We pride ourselves on making sure that everything from scheduling an appointment to coming in for a procedure is centered on you, the patient. We want to make sure that you are as comfortable as possible. Let’s be honest here, no one looks forward to a colonoscopy,  but hopefully because of our passion for patient-centered care, your experience will be as easy and comfortable as possible.

How do we do that?

The patient experience starts with our website and patient portal where all the information you need is at the tip of your fingers. We also have seven offices throughout central Virginia and perform procedures at our two endoscopy centers, making it more convenient for our patients. Our procedures are not only cost-effective, but are centered on being convenient and comfortable. We use the anesthetic agent Propofol, which is administered by an anesthesiologist with the goal of achieving a pain-free endoscopic experience. Hate waiting on results? We also offer pathology through our own lab, making it much faster to receive results. Finally, our physicians are board-certified and dedicated to offering quality, individualized care.

We are proud of what we do here at GSI and hope our passion for patient-centered care makes your experience a pleasant one.

Have you had a great patient experience with us? We’d love to hear from you!