Scientists recommends tailoring colorectal cancer screening for 45-to-49-year-olds

It’s been a year since national recommendations issued by the American Cancer Society and the U.S. Multi-Society Task Force called for colorectal cancer (CRC) screening to be lowered to include individuals ages 45 to 49 at average risk for the disease.

In a recent study, scientists issued a clarion call for individuals, clinicians, and health care systems to be good stewards of available colonoscopy resources and encourage average-risk members of this age group to consider non-invasive screening alternatives.

They suggest doctors should tailor screening to the individual—not every 45-to-49-year-old requires colonoscopy for screening.

At home, annual FIT [fecal immunochemical test] testing, which looks for blood in the stool and is inexpensive, or stool multi-target DNA and blood testing every three years, are efficient ways to screen those at the low-risk end of the average risk population, which is where most 45-to-49-year-olds fall.

Using FIT and stool DNA tests doesn’t simply benefit the individual, it benefits others who need more invasive screening resources.

There are only so many colonoscopies that can be performed well in this country every year.

Roughly seven or eight out of 10 individuals who fall within the range of those for whom colorectal cancer screening is recommended by national guidelines are considered to be at average risk of the disease.

The team says it could well be that a larger number of younger individuals will get screened if we encourage non-invasive, easy-to-use home screening tests rather than colonoscopy for ‘average-risk’ asymptomatic individuals until they get to age 50 or perhaps age 55.

The editorial notes that lowering the age at which to commence average-risk colorectal cancer screening by five years (from 50 to 45) has increased the number of people in the U.S. requiring screening by approximately 20 million.

The team supports a “hybrid” strategy of non-invasive screening for younger individuals at average risk followed by colonoscopy screening for older individuals at average risk.

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The study was conducted by Thomas Imperiale et al and published in the journal Clinical Gastroenterology and Hepatology.

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