Practice Guideline Show
. 2021 May 18;325(19):1965-1977. doi: 10.1001/jama.2021.6238. Karina W Davidson 1 , Michael J Barry 2 , Carol M Mangione 3 , Michael Cabana 4 , Aaron B Caughey 5 , Esa M Davis 6 , Katrina E Donahue 7 , Chyke A Doubeni 8 , Alex H Krist 9 10 , Martha Kubik 11 , Li Li 12 , Gbenga Ogedegbe 13 , Douglas K Owens 14 , Lori Pbert 15 , Michael Silverstein 16 , James Stevermer 17 , Chien-Wen Tseng 18 19 , John B Wong 20 Affiliations
Practice Guideline Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation StatementUS Preventive Services Task Force et al. JAMA. 2021. Erratum in
AbstractImportance: 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. It is estimated that 10.5% of new colorectal cancer cases occur in persons younger than 50 years. Incidence of colorectal cancer (specifically adenocarcinoma) in adults aged 40 to 49 years has increased by almost 15% from 2000-2002 to 2014-2016. In 2016, 26% of eligible adults in the US had never been screened for colorectal cancer and in 2018, 31% were not up to date with screening. Objective: To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) 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. In addition, as in 2016, the USPSTF commissioned a report from the Cancer Intervention and Surveillance Modeling Network Colorectal Cancer Working Group to provide information from comparative modeling on how estimated life-years gained, colorectal cancer cases averted, and colorectal cancer deaths averted vary by different starting and stopping ages for various screening strategies. Population: Asymptomatic adults 45 years or older at average risk of colorectal cancer (ie, no prior diagnosis of colorectal cancer, adenomatous polyps, or inflammatory bowel disease; no personal diagnosis or family history of known genetic disorders that predispose them to a high lifetime risk of colorectal cancer [such as Lynch syndrome or familial adenomatous polyposis]). Evidence assessment: 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. Recommendation: The USPSTF recommends screening for colorectal cancer in all adults aged 50 to 75 years. (A recommendation) The USPSTF recommends screening for colorectal cancer in adults aged 45 to 49 years. (B recommendation) 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. (C recommendation). Comment in
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What is the US preventive Services Task Forces recommendation for colorectal cancer screening?Screening Recommendations
Regular screening, beginning at age 45, is the key to preventing colorectal cancer and finding it early. The U.S. Preventive Services Task Force (Task Force) recommends that adults age 45 to 75 be screened for colorectal cancer.
When should I start colonoscopy screening USPSTF?The USPSTF recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. The decision to screen for colorectal cancer in adults aged 76 to 85 years should be an individual one, taking into account the patient's overall health and prior screening history.
How often should you get screened for colon cancer?The doctor checks for polyps or cancer inside the rectum and lower third of the colon. How often: Every 5 years, or every 10 years with a FIT every year.
Why is cologuard not recommended?Cologuard is not recommended for higher-risk patients that have had colon cancer, have a family history, have inflammatory bowel disorders like Crohn's disease or have had a personal history of colon polyps.
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