(HealthDay News) — Screening of average-risk individuals for colorectal cancer (CRC) should begin at age 50 with a stool-based test, flexible sigmoidoscopy, or colonoscopy, according to a guidance statement from the American College of Physicians (ACP) published in the March 6 issue of the Annals of Internal Medicine.
Amir Qaseem, M.D., Ph.D., and colleagues from the Clinical Guidelines Committee of the ACP, reviewed four existing U.S. guidelines for CRC screening to clarify the current recommendations.
The committee issued four guidance statements incorporating ACP recommendations. First, clinicians should perform individualized assessment of risk for CRC in all adults. Secondly, starting at age 50, clinicians should screen for CRC in average-risk adults; for high-risk adults, screening should begin at age 40, or 10 years younger than the age at which the youngest affected relative was diagnosed with CRC. Thirdly, a stool-based test, flexible sigmoidoscopy, or optical colonoscopy is recommended as a screening test for patients at average risk. For high-risk patients, an optical colonoscopy is recommended as a screening test. The test should be selected based on the benefits and harms, availability, and patient preferences. The fourth guidance statement recommends screening for colorectal cancer be stopped in adults over the age of 75 years or those with a life expectancy of less than 10 years.
“The goal of this best practice advice from the Clinical Guidelines Committee is to discuss the appropriate screening for colorectal cancer and to highlight how clinicians can contribute to delivering high-value, cost-conscious health care,” the authors conclude.