In recent years, medical organizations have updated their guidelines for colorectal cancer (CRC) screening, reflecting new research and the alarming rise in CRC cases among younger adults. These changes aim to detect cancer earlier and save more lives.
Key Updates:
Lowered Screening Age: In 2021, the U.S. Preventive Services Task Force (USPSTF) made a groundbreaking change, lowering the recommended age to start CRC screening from 50 to 45 for average-risk adults[1]. This decision was echoed by the American Cancer Society in 2018[2].
Emphasis on Personal Risk Assessment: The American Gastroenterological Association (AGA) now recommends that individuals undergo a thorough risk assessment before age 40 to determine when screening should begin[3]. This personalized approach considers factors such as family history and lifestyle.
Recognition of Alternative Screening Methods: While colonoscopy remains the gold standard, guidelines now acknowledge the value of alternative screening methods. The American College of Gastroenterology’s 2021 guidelines give a “strong recommendation” to FIT (fecal immunochemical test) as an annual non-invasive option[4].
Increased Screening Intervals for Some Tests: For those at average risk with normal results, the intervals between some screening tests have been extended. For example, the AGA now suggests that a negative colonoscopy allows for a 10-year interval before the next screening[3].
Focus on Follow-up: New guidelines emphasize the importance of follow-up after positive non-invasive tests. The USPSTF strongly recommends that positive results from stool-based tests be followed up with a timely colonoscopy[1].
Dr. Aasma Shaukat, lead author of the ACG guidelines, states, “These guidelines are an important step towards more effective CRC prevention and early detection. They reflect our evolving understanding of CRC risk factors and the effectiveness of various screening modalities”[4].
These updated guidelines underscore the medical community’s commitment to combating CRC through early detection. As screening technology advances, including the development of highly sensitive blood-based tests, we can expect further refinements to these recommendations.
Always consult with your healthcare provider to determine the most appropriate screening plan for your individual risk profile.
References:
[1] US Preventive Services Task Force. (2021). Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA, 325(19), 1965–1977. https://doi.org/10.1001/jama.2021.6238
[2] Wolf, A. M. D., Fontham, E. T. H., Church, T. R., Flowers, C. R., Guerra, C. E., LaMonte, S. J., … & Smith, R. A. (2018). Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA: A Cancer Journal for Clinicians, 68(4), 250-281. https://doi.org/10.3322/caac.21457
[3] Patel, S. G., May, F. P., Anderson, J. C., Burke, C. A., Dominitz, J. A., Gross, S. A., … & Robertson, D. J. (2022). AGA Clinical Practice Guidelines on the Management of Colorectal Cancer Screening. Gastroenterology, 163(4), 1115-1127. https://doi.org/10.1053/j.gastro.2022.06.078
[4] Shaukat, A., Kahi, C. J., Burke, C. A., Rabeneck, L., Sauer, B. G., & Rex, D. K. (2021). ACG Clinical Guidelines: Colorectal Cancer Screening 2021. American Journal of Gastroenterology, 116(3), 458-479. https://doi.org/10.14309/ajg.0000000000001122
