The U.S. Preventive Services Task Force (USPSTF), an independent panel of experts sponsored by the Agency for Healthcare Research and Quality, has issued new recommendations regarding screening for colorectal cancer. Specifically, it has given screening for this disease a “grade A recommendation,” meaning that it strongly recommends it for all adults aged 50 and older. This decision was based on new evidence from recent studies that have demonstrated the effectiveness of various screening methods in diagnosing and preventing deaths from the disease. It also is a stronger statement than the Task Force made back in 1995, when is only “recommended” colorectal cancer screening. [USPSTF grades strength of evidence from A (strongly recommends) to D (recommends against).]

Colorectal cancer is the second leading cause of death in the U.S., after lung cancer. The incidence is highest in the general population among those over the age of 50. However, the Task Force recommended screening at a younger age for those at high risk, such as individuals with a personal history of ulcerative colitis or a family history of colorectal cancer in a first-degree relative, such as a parent or sibling. (It did not recommend a specific age at which high-risk individuals should start screening.) USPSTF also suggested genetic testing for those with potentially hereditary conditions associated with this type of cancer.

The Task Force could not make a recommendation as to which screening methods are preferable due to insufficient data available at this time. It found fair to good evidence that several of the available colorectal cancer screening methods are effective in reducing mortality from this disease. These methods include at-home tests for blood in the stool (fecal occult blood tests), flexible sigmoidoscopy, colonoscopy, and double-contrast barium enema. USPSTF recommends making the decision as to which method to use in consultation with your physician based on your personal preferences, available resources, and an understanding of the advantages and disadvantages of each method. The frequency of testing also will depend on the method. There is no single test that is best for all patients or clinical practice setting.

Similar recommendations have been made by other organizations, including the American Cancer Society. [See Screening Tests for Adults (50 and Up): Colorectal Cancer] Although less than half of all Americans over the age of 50 currently do get screened for colorectal cancer, it is hoped that the message that screening can save lives will increase this number.