Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement

Colorectal cancer is the third leading cause of cancer death for both men and women, with an estimated 52 980 persons in the US projected to die of colorectal cancer in 2021. Colorectal cancer is most frequently diagnosed among persons aged 65 to 74 years. It is estimated that 10.5% of new colorecta...

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Veröffentlicht in:	JAMA : the journal of the American Medical Association Jg. 325; H. 19; S. 1965
Hauptverfasser:	Davidson, Karina W, Barry, Michael J, Mangione, Carol M, Cabana, Michael, Caughey, Aaron B, Davis, Esa M, Donahue, Katrina E, Doubeni, Chyke A, Krist, Alex H, Kubik, Martha, Li, Li, Ogedegbe, Gbenga, Owens, Douglas K, Pbert, Lori, Silverstein, Michael, Stevermer, James, Tseng, Chien-Wen, Wong, John B
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	United States 18.05.2021
Schlagworte:	Age Factors Aged Aged, 80 and over Colonoscopy - methods Colorectal Neoplasms - diagnosis Colorectal Neoplasms - ethnology Early Detection of Cancer - adverse effects Early Detection of Cancer - methods Female Humans Male Middle Aged Occult Blood Risk Sigmoidoscopy Tomography, X-Ray Computed
ISSN:	1538-3598, 1538-3598
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Abstract	Colorectal cancer is the third leading cause of cancer death for both men and women, with an estimated 52 980 persons in the US projected to die of colorectal cancer in 2021. Colorectal cancer is most frequently diagnosed among persons aged 65 to 74 years. It is estimated that 10.5% of new colorectal cancer cases occur in persons younger than 50 years. Incidence of colorectal cancer (specifically adenocarcinoma) in adults aged 40 to 49 years has increased by almost 15% from 2000-2002 to 2014-2016. In 2016, 26% of eligible adults in the US had never been screened for colorectal cancer and in 2018, 31% were not up to date with screening. To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for colorectal cancer in adults 40 years or older. The review also examined whether these findings varied by age, sex, or race/ethnicity. In addition, as in 2016, the USPSTF commissioned a report from the Cancer Intervention and Surveillance Modeling Network Colorectal Cancer Working Group to provide information from comparative modeling on how estimated life-years gained, colorectal cancer cases averted, and colorectal cancer deaths averted vary by different starting and stopping ages for various screening strategies. Asymptomatic adults 45 years or older at average risk of colorectal cancer (ie, no prior diagnosis of colorectal cancer, adenomatous polyps, or inflammatory bowel disease; no personal diagnosis or family history of known genetic disorders that predispose them to a high lifetime risk of colorectal cancer [such as Lynch syndrome or familial adenomatous polyposis]). The USPSTF concludes with high certainty that screening for colorectal cancer in adults aged 50 to 75 years has substantial net benefit. The USPSTF concludes with moderate certainty that screening for colorectal cancer in adults aged 45 to 49 years has moderate net benefit. The USPSTF concludes with moderate certainty that screening for colorectal cancer in adults aged 76 to 85 years who have been previously screened has small net benefit. Adults who have never been screened for colorectal cancer are more likely to benefit. The USPSTF recommends screening for colorectal cancer in all adults aged 50 to 75 years. (A recommendation) The USPSTF recommends screening for colorectal cancer in adults aged 45 to 49 years. (B recommendation) The USPSTF recommends that clinicians selectively offer screening for colorectal cancer in adults aged 76 to 85 years. Evidence indicates that the net benefit of screening all persons in this age group is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the patient's overall health, prior screening history, and preferences. (C recommendation).
AbstractList	Colorectal cancer is the third leading cause of cancer death for both men and women, with an estimated 52 980 persons in the US projected to die of colorectal cancer in 2021. Colorectal cancer is most frequently diagnosed among persons aged 65 to 74 years. It is estimated that 10.5% of new colorectal cancer cases occur in persons younger than 50 years. Incidence of colorectal cancer (specifically adenocarcinoma) in adults aged 40 to 49 years has increased by almost 15% from 2000-2002 to 2014-2016. In 2016, 26% of eligible adults in the US had never been screened for colorectal cancer and in 2018, 31% were not up to date with screening.ImportanceColorectal cancer is the third leading cause of cancer death for both men and women, with an estimated 52 980 persons in the US projected to die of colorectal cancer in 2021. Colorectal cancer is most frequently diagnosed among persons aged 65 to 74 years. It is estimated that 10.5% of new colorectal cancer cases occur in persons younger than 50 years. Incidence of colorectal cancer (specifically adenocarcinoma) in adults aged 40 to 49 years has increased by almost 15% from 2000-2002 to 2014-2016. In 2016, 26% of eligible adults in the US had never been screened for colorectal cancer and in 2018, 31% were not up to date with screening.To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for colorectal cancer in adults 40 years or older. The review also examined whether these findings varied by age, sex, or race/ethnicity. In addition, as in 2016, the USPSTF commissioned a report from the Cancer Intervention and Surveillance Modeling Network Colorectal Cancer Working Group to provide information from comparative modeling on how estimated life-years gained, colorectal cancer cases averted, and colorectal cancer deaths averted vary by different starting and stopping ages for various screening strategies.ObjectiveTo update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for colorectal cancer in adults 40 years or older. The review also examined whether these findings varied by age, sex, or race/ethnicity. In addition, as in 2016, the USPSTF commissioned a report from the Cancer Intervention and Surveillance Modeling Network Colorectal Cancer Working Group to provide information from comparative modeling on how estimated life-years gained, colorectal cancer cases averted, and colorectal cancer deaths averted vary by different starting and stopping ages for various screening strategies.Asymptomatic adults 45 years or older at average risk of colorectal cancer (ie, no prior diagnosis of colorectal cancer, adenomatous polyps, or inflammatory bowel disease; no personal diagnosis or family history of known genetic disorders that predispose them to a high lifetime risk of colorectal cancer [such as Lynch syndrome or familial adenomatous polyposis]).PopulationAsymptomatic adults 45 years or older at average risk of colorectal cancer (ie, no prior diagnosis of colorectal cancer, adenomatous polyps, or inflammatory bowel disease; no personal diagnosis or family history of known genetic disorders that predispose them to a high lifetime risk of colorectal cancer [such as Lynch syndrome or familial adenomatous polyposis]).The USPSTF concludes with high certainty that screening for colorectal cancer in adults aged 50 to 75 years has substantial net benefit. The USPSTF concludes with moderate certainty that screening for colorectal cancer in adults aged 45 to 49 years has moderate net benefit. The USPSTF concludes with moderate certainty that screening for colorectal cancer in adults aged 76 to 85 years who have been previously screened has small net benefit. Adults who have never been screened for colorectal cancer are more likely to benefit.Evidence AssessmentThe USPSTF concludes with high certainty that screening for colorectal cancer in adults aged 50 to 75 years has substantial net benefit. The USPSTF concludes with moderate certainty that screening for colorectal cancer in adults aged 45 to 49 years has moderate net benefit. The USPSTF concludes with moderate certainty that screening for colorectal cancer in adults aged 76 to 85 years who have been previously screened has small net benefit. Adults who have never been screened for colorectal cancer are more likely to benefit.The USPSTF recommends screening for colorectal cancer in all adults aged 50 to 75 years. (A recommendation) The USPSTF recommends screening for colorectal cancer in adults aged 45 to 49 years. (B recommendation) The USPSTF recommends that clinicians selectively offer screening for colorectal cancer in adults aged 76 to 85 years. Evidence indicates that the net benefit of screening all persons in this age group is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the patient's overall health, prior screening history, and preferences. (C recommendation).RecommendationThe USPSTF recommends screening for colorectal cancer in all adults aged 50 to 75 years. (A recommendation) The USPSTF recommends screening for colorectal cancer in adults aged 45 to 49 years. (B recommendation) The USPSTF recommends that clinicians selectively offer screening for colorectal cancer in adults aged 76 to 85 years. Evidence indicates that the net benefit of screening all persons in this age group is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the patient's overall health, prior screening history, and preferences. (C recommendation). Colorectal cancer is the third leading cause of cancer death for both men and women, with an estimated 52 980 persons in the US projected to die of colorectal cancer in 2021. Colorectal cancer is most frequently diagnosed among persons aged 65 to 74 years. It is estimated that 10.5% of new colorectal cancer cases occur in persons younger than 50 years. Incidence of colorectal cancer (specifically adenocarcinoma) in adults aged 40 to 49 years has increased by almost 15% from 2000-2002 to 2014-2016. In 2016, 26% of eligible adults in the US had never been screened for colorectal cancer and in 2018, 31% were not up to date with screening. To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for colorectal cancer in adults 40 years or older. The review also examined whether these findings varied by age, sex, or race/ethnicity. In addition, as in 2016, the USPSTF commissioned a report from the Cancer Intervention and Surveillance Modeling Network Colorectal Cancer Working Group to provide information from comparative modeling on how estimated life-years gained, colorectal cancer cases averted, and colorectal cancer deaths averted vary by different starting and stopping ages for various screening strategies. Asymptomatic adults 45 years or older at average risk of colorectal cancer (ie, no prior diagnosis of colorectal cancer, adenomatous polyps, or inflammatory bowel disease; no personal diagnosis or family history of known genetic disorders that predispose them to a high lifetime risk of colorectal cancer [such as Lynch syndrome or familial adenomatous polyposis]). The USPSTF concludes with high certainty that screening for colorectal cancer in adults aged 50 to 75 years has substantial net benefit. The USPSTF concludes with moderate certainty that screening for colorectal cancer in adults aged 45 to 49 years has moderate net benefit. The USPSTF concludes with moderate certainty that screening for colorectal cancer in adults aged 76 to 85 years who have been previously screened has small net benefit. Adults who have never been screened for colorectal cancer are more likely to benefit. The USPSTF recommends screening for colorectal cancer in all adults aged 50 to 75 years. (A recommendation) The USPSTF recommends screening for colorectal cancer in adults aged 45 to 49 years. (B recommendation) The USPSTF recommends that clinicians selectively offer screening for colorectal cancer in adults aged 76 to 85 years. Evidence indicates that the net benefit of screening all persons in this age group is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the patient's overall health, prior screening history, and preferences. (C recommendation).
Author	Li, Li Cabana, Michael Barry, Michael J Donahue, Katrina E Ogedegbe, Gbenga Pbert, Lori Caughey, Aaron B Doubeni, Chyke A Tseng, Chien-Wen Davidson, Karina W Mangione, Carol M Krist, Alex H Davis, Esa M Owens, Douglas K Stevermer, James Silverstein, Michael Kubik, Martha Wong, John B
Author_xml	– sequence: 1 givenname: Karina W surname: Davidson fullname: Davidson, Karina W organization: Feinstein Institute for Medical Research at Northwell Health, Manhasset, New York – sequence: 2 givenname: Michael J surname: Barry fullname: Barry, Michael J organization: Harvard Medical School, Boston, Massachusetts – sequence: 3 givenname: Carol M surname: Mangione fullname: Mangione, Carol M organization: University of California, Los Angeles – sequence: 4 givenname: Michael surname: Cabana fullname: Cabana, Michael organization: Albert Einstein College of Medicine, New York, New York – sequence: 5 givenname: Aaron B surname: Caughey fullname: Caughey, Aaron B organization: Oregon Health & Science University, Portland – sequence: 6 givenname: Esa M surname: Davis fullname: Davis, Esa M organization: University of Pittsburgh, Pittsburgh, Pennsylvania – sequence: 7 givenname: Katrina E surname: Donahue fullname: Donahue, Katrina E organization: University of North Carolina at Chapel Hill – sequence: 8 givenname: Chyke A surname: Doubeni fullname: Doubeni, Chyke A organization: Mayo Clinic, Rochester, Minnesota – sequence: 9 givenname: Alex H surname: Krist fullname: Krist, Alex H organization: Virginia Commonwealth University, Richmond – sequence: 10 givenname: Martha surname: Kubik fullname: Kubik, Martha organization: George Mason University, Fairfax, Virginia – sequence: 11 givenname: Li surname: Li fullname: Li, Li organization: University of Virginia, Charlottesville – sequence: 12 givenname: Gbenga surname: Ogedegbe fullname: Ogedegbe, Gbenga organization: New York University, New York, New York – sequence: 13 givenname: Douglas K surname: Owens fullname: Owens, Douglas K organization: Stanford University, Stanford, California – sequence: 14 givenname: Lori surname: Pbert fullname: Pbert, Lori organization: University of Massachusetts Medical School, Worcester – sequence: 15 givenname: Michael surname: Silverstein fullname: Silverstein, Michael organization: Boston University, Boston, Massachusetts – sequence: 16 givenname: James surname: Stevermer fullname: Stevermer, James organization: University of Missouri, Columbia – sequence: 17 givenname: Chien-Wen surname: Tseng fullname: Tseng, Chien-Wen organization: Pacific Health Research and Education Institute, Honolulu, Hawaii – sequence: 18 givenname: John B surname: Wong fullname: Wong, John B organization: Tufts University School of Medicine, Boston, Massachusetts
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/34003218$$D View this record in MEDLINE/PubMed
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Snippet	Colorectal cancer is the third leading cause of cancer death for both men and women, with an estimated 52 980 persons in the US projected to die of colorectal...
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SubjectTerms	Age Factors Aged Aged, 80 and over Colonoscopy - methods Colorectal Neoplasms - diagnosis Colorectal Neoplasms - ethnology Early Detection of Cancer - adverse effects Early Detection of Cancer - methods Female Humans Male Middle Aged Occult Blood Risk Sigmoidoscopy Tomography, X-Ray Computed
Title	Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement
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