ACS issues new CRC screening guidelines

  • Wolf AMD & al.
  • CA Cancer J Clin
  • 30 May 2018

  • Oncology guidelines update
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Takeaway

  • The American Cancer Society (ACS) has issued updated guidelines on the diagnosis and treatment of colorectal cancer (CRC) in adults at average risk, including a recommendation to begin screening in this population at age 45 years and when to discontinue screening.

Why this matters

  • Studies have yielded new evidence on CRC risk, screening, and performance of various screening modalities since the ACS guidelines were last updated in 2008.

Key recommendations

  • All average-risk adults should begin CRC screening at age 45 years, and screening should continue in those in good health through age 75 years.
  • Recommended test options for CRC screening are annual fecal immunochemical testing or high-sensitivity guaiac fecal occult blood test, multitarget stool DNA test every 3 years, colonoscopy every 10 years, CT colonography every 5 years, and flexible sigmoidoscopy every 5 years.
  • Double-contrast barium enema is no longer an acceptable screening option.
  • Recommended screening intervals are unchanged.
  • Clinicians should individualize CRC screening decisions for individuals aged 76-85 years, based on patient preferences, life expectancy, health status, and prior screening history.
  • Screening after age 85 years is discouraged.
  • Guidelines stress patient choice in screening modality.
  • No recommendations on screening for patients at increased or high risk for CRC.

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