New clinical guidelines advise against universal colorectal cancer (CRC) screening for people aged 50-79 years.
The guidelines, developed by an international panel of experts, are published in a BMJ Rapid Recommendation article.
Numerous guidelines recommend screening, but vary on recommended test, age and screening frequency. This guideline looks at the evidence and makes recommendations on four screening options: faecal immunochemical test (FIT) every year, FIT every two years, single sigmoidoscopy or single colonoscopy, for adults aged 50-79 years with no prior screening, no symptoms of CRC and a life expectancy of at least 15 years.
Based on current evidence, the guidelines advise against screening for individuals with an estimated 15-year CRC risk below 3 per cent (weak recommendation). For individuals with an estimated 15-year risk above 3 per cent, the panel recommends screening with any of the four options studied (weak recommendation).
Overall, there was substantial uncertainty regarding the 15-year benefits, burdens and harms of screening. Best estimates suggested that all four options resulted in similar CRC mortality reductions. However, FIT every two years may have little or no effect on cancer incidence over 15 years, the experts say.
The full guidelines are available here.