Colorectal cancer (CRC) is the third most common new site and cause of cancer death in the US. While most cases will be diagnosed between the ages of 65 and 74 years, approximately 10.5% will occur in individuals <50 years. USPSTF has updated guidelines that recommend screening starting at age 45. There are currently multiple screening strategies available and professional guidelines may differ in approach.
The USPSTF recommends the following
Note: An individual with a family history of multiple relatives with CRC is not a candidate for average CRC screening | Such an individual should be considered at higher risk and would benefit from further assessment, including genetic counseling for a heritable cancer syndrome
Stool-Based Tests
Tests other than colonoscopies that can be used for screening of average risk patients
Direct Visualization Tests
Colorectal Cancer Burden
Advising Black Adults
The USPSTF recognizes the higher colorectal cancer incidence and mortality in Black adults and strongly encourages clinicians to ensure their Black patients receive recommended colorectal cancer screening, follow-up, and treatment
The USPSTF encourages the development of systems of care to ensure adults receive high-quality care across the continuum of screening and treatment, with special attention to Black communities, which historically experience worse colorectal cancer health outcomes
American College of Gastroenterology (2021)
Canadian Guidelines (2016)
Note: Recommend not using colonoscopy
American Cancer Society (2018)
ACP (2019)
JAMA: Screening for Colorectal Cancer US Preventive Services Task Force Recommendation Statement
ACG Clinical Guidelines: Colorectal Cancer Screening 2021
Canadian Task Force on Preventive Health Care
American Cancer Society Guideline for Colorectal Cancer Screening
BMJ State of the Art Review: Screening and prevention of colorectal cancer
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