Colorectal Cancer Screening

ACP Releases Colorectal Cancer Screening Guidance

The American College of Physicians (ACP) has released new guidelines for colorectal cancer screening in asymptomatic, average-risk adults.

The new guidelines are an attempt to reconcile various conflicting guidelines on colorectal cancer screening.

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“Guidelines disagree on the age to start and stop screening, screening interval, and recommended screening method. Strategies differ in the quality of evidence regarding clinical effectiveness, harms, patient burden, recommended frequency of administration, and test accuracy,” the authors wrote.

The ACP Clinical Guideline Committee, which develops statements on topics with several available conflicting recommendations, searched the National Guideline Clearinghouse and the Guidelines International Network library for colorectal cancer screening guidelines developed by national-level organizations between June 1, 2014 and May 28, 2018.

Among the guidance statements:

  • Average-risk adults between the ages of 50 and 75 years should undergo screening for colorectal cancer.
  • Clinicians should discuss available colorectal cancer screening tests with their patients. Suggested tests include fecal immunochemical testing or high-sensitivity guaiac-based fecal occult blood testing every 2 years, colonoscopy every 10 years, or flexible sigmoidoscopy every 10 years plus fecal immunochemical testing every 2 years.
  • Screening should be discontinued in average-risk adults older than 75 years or in adults with life expectancy of 10 years or less.

 

—Michael Potts

Reference:

Qaseem A, Crandall CJ, Mustafa RA, Hicks LA, Wilt TJ; the Clinical Guidelines Committee of the American College of Physicians. Screening for colorectal cancer in asymptomatic average-risk adults: a guidance statement from the American College of Physicians. Ann Intern Med. 2019;171(9):643-654. doi:10.7326/M19-0642.