The U.S. Multi-Society Task Force on Colorectal Cancer issued several new recommendations and introduced a "tier ranking system" concerning colorectal cancer screening tests.
The task force noted colorectal cancer incidence rate in people 50 years and older is declining. The task force recommends beginning screenings at 50 years old for a majority of the population and 45 years old for African Americans. The African American population has lower screening rates with higher incidence rates. CRC also affects the African American population at an early age, resulting in the recommendation.
The task force consists of American Society for Gastrointestinal Endoscopy, American College of Gastroenterology and American Gastroenterological Association members. The group evaluated seven screening tests.
Here's what you should know:
1. The task force established three tiers of screening tests for average-risk people:
- Tier 1
- Colonoscopy every decade
- Annual fecal immunotherapy test
- Tier 2
- CT colonography every five years
- FIT-fecal DNA test every three years
- Flexible sigmoidoscopy every five to 10 years
- Tier 3
- Capsule colonoscopy every five years
2.The task force does not recommend Septin9, a blood-based test.
3. Concerning the tiers, the task force recommends:
- Screening colonoscopies should measure quality, including adenoma detection rate
- FIT tests need to monitor quality
- Physicians should elevate patients who refuse colonoscopy or FIT to tier two, and those who decline tier 2 tests should be elevated to tier 3
4. If a patient's family member had colon cancer before they were 60 years old, the task force recommends first-degree relatives to undergo a colonoscopy when they turn 40 years old, or 10 years before the family member was diagnosed.
The task force recommends patients' with a first-degree relative with advanced adenoma or advanced serrated lesions follow the aforementioned guideline.
5. Colorectal cancer is increasing in people under 50 years old. Although still low, the task force believes this is a "major public health concern."
6. The task force published the recommendations in full in Gastroenterology, The American Journal of Gastroenterology and GIE: Gastrointestinal Endoscopy.
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