An updated American Cancer Society guideline says colorectal cancer screening should begin at age 45 for people at average risk, based in part on data showing rates of colorectal cancer are increasing in young and middle-aged populations.
The new recommended starting age is based on colorectal cancer (CRC) incidence rates, results from microsimulation modeling that demonstrate a favorable benefit-to-burden balance of screening beginning at age 45, and the expectation that screening will perform similarly in adults ages 45 to 49 as it does in adults for whom screening is currently recommended (50 and older). The updated recommendations are published early online in CA: A Cancer Journal for Clinicians, a peer-reviewed journal of the American Cancer Society.
The American Cancer Society recommends:
Adults ages 45 and older with an average risk of colorectal cancer undergo regular screening with either a high-sensitivity stool-based test or a structural (visual) exam, depending on patient preference and test availability. The change in starting age is designated as a “qualified recommendation,” because there is less direct evidence of the balance of benefits and harms, or patients’ values and preferences, related to CRC screening in adults aged 45-49 since most studies have only included adults aged
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