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ACS Updates Colorectal Cancer Screening to Start at Age 45

Average-risk adults aged 45+ should undergo high-sensitivity stool-based test, structural exam

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WEDNESDAY, May 30, 2018 (HealthDay News) -- 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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