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Colorectal Cancer Screening Should Start at Age 45 Years

Recommendation based on increasing disease burden in those younger than 50 years, modeling studies demonstrating benefits outweighing harms, costs of screening

TUESDAY, Dec. 7, 2021 (HealthDay News) — Average-risk colorectal cancer (CRC) screening should start at age 45 years, according to U.S. Multi-Society Task Force on Colorectal Cancer recommendations published online Nov. 15 in Gastroenterology.

Swati G. Patel, M.D., from the University of Colorado Anschutz Medical Center in Aurora, and colleagues updated 2017 screening recommendations addressing the age to start and stop CRC screening in average-risk individuals.

The authors note there are sufficient data to support the suggestion that average-risk CRC screening begin at age 45 years even though there is no literature demonstrating that CRC screening in individuals younger than age 50 years improves health outcomes such as CRC incidence or mortality. This recommendation is based on increasing disease burden in individuals younger than age 50 years, emerging data relating to the prevalence of advanced colorectal neoplasia among individuals aged 45 to 49 years approaching rates in those aged 50 to 59 years, and modeling studies demonstrating benefits outweighing putative harms and costs of screening. The decision to start or continue screening should be individualized for those ages 76 to 85 years and should be based on prior history of screening, life expectancy, CRC risk, and personal preference. After age 85 years, screening is not recommended.

“Our recommendation is in congruence with emerging recommendations from other professional societies who are also supporting average-risk CRC screening starting at age 45 on a qualified basis,” the authors write.

Several authors disclosed financial ties to the biopharmaceutical and medical device industries.

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