Screening for Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement

TLDR

This update revises the 2002 USPSTF recommendation on colorectal cancer screening, noting that risks and benefits differ among methods and that individual patient factors may influence screening decisions. The USPSTF updated its recommendation by conducting a systematic evidence review of test characteristics and a decision‑analytic model comparing health outcomes and resource use of screening modalities over time. The USPSTF recommends screening adults aged 50–75 with fecal occult blood testing, sigmoidoscopy, or colonoscopy, advises against routine screening for ages 76–85 and beyond 85, and finds insufficient evidence for computed tomographic colonography and fecal DNA testing. I statement.

Abstract

Description: Update of the 2002 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for colorectal cancer. Methods: To update its recommendation, the USPSTF commissioned 2 studies: 1) a targeted systematic evidence review on 4 selected questions relating to test characteristics and benefits and harms of screening technologies, and 2) a decision analytic modeling analysis using population modeling techniques to compare the expected health outcomes and resource requirements of available screening modalities when used in a programmatic way over time. Recommendations: The USPSTF recommends screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonoscopy in adults, beginning at age 50 years and continuing until age 75 years. The risks and benefits of these screening methods vary. (A recommendation) The USPSTF recommends against routine screening for colorectal cancer in adults 76 to 85 years of age. There may be considerations that support colorectal cancer screening in an individual patient. (C recommendation) The USPSTF recommends against screening for colorectal cancer in adults older than age 85 years. (D recommendation) The USPSTF concludes that the evidence is insufficient to assess the benefits and harms of computed tomographic colonography and fecal DNA testing as screening modalities for colorectal cancer. (I statement)