The U.S. Multisociety Task Force on Colorectal Cancer—representing the American College of Gastroenterology, the American Gastroenterological Association, and the American Society for Gastrointestinal Endoscopy—has updated its colorectal cancer screening recommendations, which were last published in 2017. The new guidance focuses specifically on when to start and when to stop colorectal cancer screening in average-risk individuals. The full recommendations have been published jointly online by Patel et al via Gastrointestinal Endoscopy, Gastroenterology, and The American Journal of Gastroenterology and will be available in the January 2022 print issues of these publications.
Updated Guidance
Included in the new guidance, the task force now suggests colorectal cancer screening in average-risk individuals aged 45 to 49. Unchanged from 2017 are the following recommendations:
- The task force strongly recommends colorectal cancer screening for individuals aged 50 to 75 who have not already initiated screening.
- For individuals aged 76 to 85, the decision to start or continue screening should be individualized and based on screening history, comorbidity, life expectancy, colorectal cancer risk, and personal preference.
- Screening is not recommended after age 85.
The task force made these determinations based on evidence demonstrating an increasing incidence and mortality from colorectal cancer in individuals younger than 50, with data suggesting that the yield of screening in 45- to 49-year-old individuals is similar to the yield of screening 50- to 59-year-olds and that the benefits of screening in younger individuals outweigh the harms and costs based on modeling studies. In addition, the task force summarized new data since 2017 regarding the risks and benefits of screening beyond age 75 and the appropriate age to stop screening.
This updated guidance from the Multisociety Task Force is aligned with multiple other professional societies, including the U.S. Preventive Services Task Force, the National Comprehensive Cancer Network, and the American Cancer Society.
Disclosure: For full disclosures of the guideline authors, visit www.giejournal.org or www.gastrojournal.org.
