The American College of Physicians updated its guidance for colorectal cancer screenings in asymptomatic, average-risk adults. The organization last issued guidance on screenings in 2019 but added several new guidance statements in an Aug. 1 study published in Annals of Internal Medicine.
The new guidelines are based on medical journal articles and guidelines published in the U.S. and England between January 2018 and August 2023. Evidence reviews and modeling studies were used to synthesize the evidence of diagnostic test accuracy, effectiveness and harms of colorectal cancer screening interventions and develop new guidance.
Here are the ACP's newest guidance statements for colorectal cancer screenings:
- Clinicians should start colorectal cancer screenings in asymptomatic, average-risk adults at the age of 50.
- Clinicians should consider not screening asymptomatic, average-risk adults between the ages of 45 and 49. Clinicians should discuss benefits and harms with patients of screening in this population.
- Clinicians should stop screening asymptomatic, average-risk adults older than 75 and average-risk adults with a life expectancy of 10 years or less.
- Clinicians should select a screening test in consultation with patients based on a discussion of benefits, harms, cost, availability, frequency and patient values and preferences.
- Clinicians should perform a fecal immunochemical or high-sensitivity guaiac fecal occult blood test every two years, colonoscopy every 10 years, or flexible sigmoidoscopy every 10 years plus a fecal immunochemical test every two years as screening test options for colorectal cancer.
- Clinicians should not use stool DNA, computed tomography colonography, capsule endoscopy, urine or serum screening tests for colorectal cancer.