USPSTF Recommends Earlier Screening for Colorectal Cancer


The USPSTF recommends that colorectal cancer screening start at age 45.

The US Preventive Services Task Force (USPSTF) posted a draft B recommendation for colorectal cancer (CRC) screening to start at age 45, instead of 50, which current cancer guidelines suggest. The task force also still strongly recommends that individuals between the ages of 50 and 75 be screened as well, to reduce their risk of dying from the disease.

“Unfortunately, not enough people in the U.S. receive this effective preventive service that has been proven to save lives,” said Task Force chair Alex Krist, MD, MPH, in a statement. “We hope that this recommendation to screen people ages 45 to 75 for colorectal cancer will encourage more screening and reduce people's risk of dying from this disease.”

There has been an uptick in the percentage of younger adults diagnosed with CRC in recent years. In September 2019, the FDA approved an at-home, stool-based CRC test for eligible, at-risk people under the age of 45. Now, the USPSTF recommends that people use 1 of 2 screening methods: direct visualization tests or stool-based tests.

These recommendations align with a statement from the American Cancer Society. In June 2020, the organization recommended that people at average risk start regular CRC screening at age 45.

“There are many tests available that can effectively screen for colorectal cancer,” says Task Force member Martha Kubik, PhD, RN. “We urge primary care clinicians to discuss the pros and cons of the various recommended options with their patients to help decide which test is best for each person.”

Additionally, the USPSTF maintains its C recommendation (meaning that it depends on each patient’s situation) that screening should be made on a per-patient basis for individuals between the ages of 76 and 85. This is for adults who do not exhibit any symptoms, do not have a history of colorectal polyps, and do not have a personal or family health history of colorectal cancer or genetic disorders that increase risk for the disease.

Nurses and other oncology clinicians should be sure to talk with their Black patients about early screening, as Black adults are diagnosed with CRC more often that other populations and also have higher death rates from the disease.

“New science about colorectal cancer in younger people has enabled us to expand our recommendation to screen all adults starting at age 45, especially Black adults who are more likely to die from this disease,” says Task Force member Michael Barry, M.D. “Screening earlier will help prevent more people from dying from colorectal cancer.”

More: Disparities Exist in Younger Adults with GI Cancers

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