Updates on Age to Start and Stop Colorectal Cancer Screening: Recommendations From the U.S. Multi-Society Task Force on Colorectal Cancer
- Study type
- Clinical guideline
- Study name
- USMSTF CRC Screening Age Update 2022
- Design
- Clinical guideline (focused update of the 2017 recommendations of the U.S. Multi-Society Task Force on Colorectal Cancer)
- Source
- Gastroenterology · 2022
In plain words
Specialist gastroenterology societies in the United States suggest that people at average risk of colorectal (bowel) cancer start screening at age 45, because this cancer is being seen more often in people younger than 50. For people aged 76 to 85, whether to continue screening should be decided with the doctor, based on past screening, general health and the person's own wishes. After age 85, screening is not recommended.
Key guideline recommendations
- Suggestion (level of evidence not stated in the abstract)
Despite the absence of sources showing that CRC screening in people under 50 years improves outcomes such as CRC incidence or CRC-related mortality, it is suggested that CRC screening in average-risk people begin at age 45.
- Individualised decision-making (level of evidence not stated in the abstract)
For people aged 76 to 85 years, the decision to start or continue screening should be individualised, based on prior screening history, life expectancy, CRC risk and personal preference.
- Level of evidence not stated in the abstract
Screening is not recommended after age 85.
Study population
People at average risk of colorectal cancer. This update addresses only the age to start and stop screening in average-risk people and the recommended screening methods.
Endpoints
This document is a guideline and has no trial endpoint. The recommendations are based on the rising disease burden in people under 50 years, emerging data on the prevalence of advanced colorectal neoplasia at ages 45 to 49 years, and modelling studies of the benefits, harms and costs of screening.
Safety and side effects
The abstract does not specifically report harms; it only notes that modelling studies show the benefits of screening outweigh its potential harms and costs.
Clinical significance and place in guidelines
This update lowered the suggested age to start screening in average-risk people to 45 years and recommended individualised decision-making for ages 76 to 85 years. Note that this recommendation is based on rising disease burden, prevalence data and modelling, and no study has shown an improvement in incidence or mortality below age 50. The current status of other guidelines and their applicability to other populations should be checked by the physician.
Limitations
According to the abstract, no source shows that screening in people under 50 years improves CRC incidence or mortality; the recommendation relies on indirect data and modelling. This update covers only average-risk people. Note: an erratum has been published for this article.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.