Recommended Age for Colorectal Cancer Screenings Lowered from 50 to 45

The United States Preventive Services Task Force announced a new recommendation today for colorectal cancer screenings, lowering the recommended age to begin screenings from 50 to 45 years of age. The task force also recommended selective screenings among adults 76 to 85 years of age based on their overall health and prior screening history.1

All adults between 45 and 75 years of age should be screened for colon and rectal cancers, according to the recommendation. This includes people of average risk who have no symptoms or prior diagnosis of colorectal cancer, as well as those with no history of colon or rectal polyps or family history of genetic disorders that put them at a higher risk for these cancers.1

Colorectal cancer is the third leading cause of cancer deaths for both men and women, according to the task force recommendation, which estimated that 52,980 people in the United States will die of colorectal cancer in 2021. Although it is most frequently diagnosed in patients 65 to 74 years of age, the recommendation said that approximately 10.5% of new cases occur in people younger than 50 years.1

Notably, the incidence of colorectal cancer in adults between 40 and 49 years of age has increased by nearly 15% since 2000. In 2016, 25.6% of eligible adults in the United States had never been screened for colorectal cancer, and in 2018, 31.2% were not up to date with screening.1 These trends are a major cause of the new recommendation, according to the task force.2

“Far too many people in the US are not receiving this lifesaving preventive service,” said task force Vice Chair Michael Barry, MD, in a press release. “We hope that this new recommendation to screen people ages 45 to 59, coupled with our long-standing recommendation to screen people 50 to 75, will prevent more people from dying from colorectal cancer.”2

The recommendation includes 2 types of screenings for colorectal cancer: direct visualization tests and stool-based tests.2

“Based on the evidence, there are many tests available that can effectively screen for colorectal cancer, and the right test is the one that gets done,” said task force member Martha Kubik, PhD, RN, in the press release. “To encourage screening and help patients select the best test for them, we urge primary care clinicians to talk about the pros and cons of the various recommended options with their patients.”2

In addition to these broad recommendations for all patients 45 years of age and older, the recommendation noted disparities among Black Americans. Between 2013 and 2017, the recommendation said there were 43.6 cases of colorectal cancer per 100,000 Black adults, compared to 37.8 cases per 100,000 White adults.1 To help address these disparities, the press release said the task force members urge clinicians to reach out to their Black patients to help make sure they are receiving regular screenings.2

REFERENCES

1. Final Recommendation Statement: Screening for Colorectal Cancer. US Preventive Services Task Force; May 18, 2021. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Accessed May 18, 2021.

2. US Preventive Services Task Force Issues Final Recommendation on Screening for Colorectal Cancer [news release]. US Preventive Services Task Force; May 18, 2021. https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/colorectal-cancer-screening-final-rec-bulletin.pdf. Accessed May 18, 2021.