- 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.
- 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.