Colorectal cancer screenings should start at age 45, says new UPSTF guideline
USA: The US Preventive Services Task Force (USPSTF) has released an updated version of recommendation on screening for colorectal cancer.
The guideline changes, published in the current issue of JAMA, updates its 2016 recommendations and aligns them with those of the American Cancer Society, which lowered the age for initiation of screening to 45 years in 2018.
According to the recommendations, colorectal cancer screenings should begin for adults at age 45, instead of the previous standard of screenings beginning at age 50. Also, clinicians should selectively offer to screen to adults 76 to 85 years of age.
Colorectal cancer is the third leading cause of cancer death for both men and women, with an estimated 52 980 persons in the US projected to die of colorectal cancer in 2021. Colorectal cancer is most frequently diagnosed among persons aged 65 to 74 years.
To update the 2016 recommendation, the task force commissioned a systematic review to evaluate the benefits and harms of screening for colorectal cancer in adults 40 years or older. The review also examined whether these findings varied by age, sex, or race/ethnicity.
Key recommendations include:
- The USPSTF recommends screening for colorectal cancer in all adults aged 50 to 75 years.
- The USPSTF recommends screening for colorectal cancer in adults aged 45 to 49 years.
- The USPSTF recommends that clinicians selectively offer screening for colorectal cancer in adults aged 76 to 85 years. Evidence indicates that the net benefit of screening all persons in this age group is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the patient's overall health, prior screening history, and preferences.
"The USPSTF concludes with high certainty that screening for colorectal cancer in adults aged 50 to 75 years has substantial net benefit. The USPSTF concludes with moderate certainty that screening for colorectal cancer in adults aged 45 to 49 years has moderate net benefit. The USPSTF concludes with moderate certainty that screening for colorectal cancer in adults aged 76 to 85 years who have been previously screened has small net benefit. Adults who have never been screened for colorectal cancer are more likely to benefit," wrote the authors.
"Screening for Colorectal Cancer US Preventive Services Task Force Recommendation Statement," is published in the Journal of the American Medical Association.