International guideline recommends against universal CRC screening

A new internationally developed guideline recommends against screening all people aged 50 to 79 years for colorectal cancer, instead recommending only individuals of elevated risk undergo a screening test, Medscape reports.

The guideline, published in BMJ, suggests individuals with a cumulative cancer risk score of 3 percent or higher undergo either a fecal immunochemical test every year, FIT every two years, a one-time sigmoidoscopy or a one-time colonoscopy. For everyone under 3 percent, the guideline recommends bypassing screening.

The guideline was based on research including a systematic review of screening trials, including data from three recently released trials related to one-time sigmoidoscopy. The guideline was developed through BMJ's Rapid Recommendations initiative, which aims to develop guidelines using the newest evidence.

The guideline authors suggest using cumulative risk, based on a person's gender, age, body mass index, physical activity level, familial history and presence of predisposing CRC diseases. They said while the recommendation is likely to be controversial, the cumulative risk of developing bowel cancer in most people ranges from 1 percent to 7 percent over the next 15 years. The group believes by screening only high-risk individuals, physicians can better optimize screening effectiveness.

Read the full Medscape article here.
Read the full guideline here.
Read the accompanying editorial here.

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