ACS Updates Colorectal Cancer Screening to Start at Age 45

 Colorectal cancer (CRC) screening should begin at age 45 for people at average risk, according to updated guidelines from the American Cancer Society published online May 30 in CA: A Cancer Journal for Clinicians.

Andrew M.D. Wolf, M.D., from the University of Virginia School of Medicine in Charlottesville, and colleagues conducted a systematic evidence review of the CRC screening literature and microsimulation modeling analyses.

The authors note that screening with any of the multiple options is associated with a significant reduction in CRC incidence and mortality. Adults aged 45 years and older with an average CRC risk are advised to undergo regular screening with a high-sensitivity stool-based test or structural (visual) examination, depending on patient preference and availability of the tests. All positive results of non-colonoscopy screening tests should be followed-up with timely colonoscopy as part of the screening process. The recommendation to begin screening at age 45 years is a qualified recommendation, while there is a strong recommendation for starting regular screening in adults aged 50 years and older. Other qualified recommendations include screening through age 75 years for average-risk adults; individualized CRC screening decisions for those aged 76 to 85 years; and discouraging adults aged ≥85 from continuing CRC screening.

"It is our hope that widespread adoption of this guideline will have a major impact on the incidence, suffering, and mortality caused by CRC," the authors write.

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