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Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement

Practice Guideline

. 2016 Jun 21;315(23):2564-2575. doi: 10.1001/jama.2016.5989. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement Kirsten Bibbins-Domingo¹, David C Grossman², Susan J Curry³, Karina W Davidson⁴, John W Epling Jr⁵, Francisco A R García⁶, Matthew W Gillman⁷, Diane M Harper⁸, Alex R Kemper⁹, Alex H Krist¹⁰, Ann E Kurth¹¹, C Seth Landefeld¹², Carol M Mangione¹³, Douglas K Owens¹⁴, William R Phillips¹⁵, Maureen G Phipps¹⁶, Michael P Pignone¹⁷, Albert L Siu¹⁸

Affiliations

¹ University of California, San Francisco.
² Group Health Research Institute, Seattle, Washington.
³ University of Iowa, Iowa City.
⁴ Columbia University, New York, New York.
⁵ State University of New York Upstate Medical University, Syracuse.
⁶ Pima County Department of Health, Tucson, Arizona.
⁷ Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
⁸ University of Louisville, Kentucky.
⁹ Duke University, Durham, North Carolina.
¹⁰ Fairfax Family Practice Residency, Fairfax, Virginia11Virginia Commonwealth University, Richmond.
¹¹ Yale University, New Haven, Connecticut.
¹² University of Alabama at Birmingham.
¹³ University of California, Los Angeles.
¹⁴ Veterans Affairs Palo Alto Health Care System, Palo Alto, California16Stanford University, Stanford, California.
¹⁵ University of Washington, Seattle.
¹⁶ Brown University, Providence, Rhode Island.
¹⁷ University of North Carolina, Chapel Hill.
¹⁸ Mount Sinai School of Medicine, New York, New York21James J. Peters Veterans Affairs Medical Center, Bronx, New York.

PMID: 27304597
DOI: 10.1001/jama.2016.5989

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Practice Guideline

Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement

US Preventive Services Task Force et al. JAMA. 2016.

. 2016 Jun 21;315(23):2564-2575. doi: 10.1001/jama.2016.5989. Authors US Preventive Services Task Force; Kirsten Bibbins-Domingo¹, David C Grossman², Susan J Curry³, Karina W Davidson⁴, John W Epling Jr⁵, Francisco A R García⁶, Matthew W Gillman⁷, Diane M Harper⁸, Alex R Kemper⁹, Alex H Krist¹⁰, Ann E Kurth¹¹, C Seth Landefeld¹², Carol M Mangione¹³, Douglas K Owens¹⁴, William R Phillips¹⁵, Maureen G Phipps¹⁶, Michael P Pignone¹⁷, Albert L Siu¹⁸ Affiliations

¹ University of California, San Francisco.
² Group Health Research Institute, Seattle, Washington.
³ University of Iowa, Iowa City.
⁴ Columbia University, New York, New York.
⁵ State University of New York Upstate Medical University, Syracuse.
⁶ Pima County Department of Health, Tucson, Arizona.
⁷ Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
⁸ University of Louisville, Kentucky.
⁹ Duke University, Durham, North Carolina.
¹⁰ Fairfax Family Practice Residency, Fairfax, Virginia11Virginia Commonwealth University, Richmond.
¹¹ Yale University, New Haven, Connecticut.
¹² University of Alabama at Birmingham.
¹³ University of California, Los Angeles.
¹⁴ Veterans Affairs Palo Alto Health Care System, Palo Alto, California16Stanford University, Stanford, California.
¹⁵ University of Washington, Seattle.
¹⁶ Brown University, Providence, Rhode Island.
¹⁷ University of North Carolina, Chapel Hill.
¹⁸ Mount Sinai School of Medicine, New York, New York21James J. Peters Veterans Affairs Medical Center, Bronx, New York.

PMID: 27304597
DOI: 10.1001/jama.2016.5989

Item in Clipboard

Erratum in

Incorrect Test Name.
[No authors listed] [No authors listed] JAMA. 2016 Aug 2;316(5):545. doi: 10.1001/jama.2016.9943. JAMA. 2016. PMID: 27483080 No abstract available.
Incorrect Data in Abstract, Text, and Figure.
[No authors listed] [No authors listed] JAMA. 2017 Jun 6;317(21):2239. doi: 10.1001/jama.2017.5918. JAMA. 2017. PMID: 28586871 No abstract available.

Abstract

Importance: Colorectal cancer is the second leading cause of cancer death in the United States. In 2016, an estimated 134,000 persons will be diagnosed with the disease, and about 49,000 will die from it. Colorectal cancer is most frequently diagnosed among adults aged 65 to 74 years; the median age at death from colorectal cancer is 68 years.

Objective: To update the 2008 US Preventive Services Task Force (USPSTF) recommendation on screening for colorectal cancer.

Evidence review: The USPSTF reviewed the evidence on the effectiveness of screening with colonoscopy, flexible sigmoidoscopy, computed tomography colonography, the guaiac-based fecal occult blood test, the fecal immunochemical test, the multitargeted stool DNA test, and the methylated SEPT9 DNA test in reducing the incidence of and mortality from colorectal cancer or all-cause mortality; the harms of these screening tests; and the test performance characteristics of these tests for detecting adenomatous polyps, advanced adenomas based on size, or both, as well as colorectal cancer. The USPSTF also commissioned a comparative modeling study to provide information on optimal starting and stopping ages and screening intervals across the different available screening methods.

Findings: The USPSTF concludes with high certainty that screening for colorectal cancer in average-risk, asymptomatic adults aged 50 to 75 years is of substantial net benefit. Multiple screening strategies are available to choose from, with different levels of evidence to support their effectiveness, as well as unique advantages and limitations, although there are no empirical data to demonstrate that any of the reviewed strategies provide a greater net benefit. Screening for colorectal cancer is a substantially underused preventive health strategy in the United States.

Conclusions and recommendations: The USPSTF recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years (A recommendation). The decision to screen for colorectal cancer in adults aged 76 to 85 years should be an individual one, taking into account the patient's overall health and prior screening history (C recommendation).

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Comment in

Colorectal Cancer Screening.
Pinsky PF, Doroudi M. Pinsky PF, et al. JAMA. 2016 Oct 25;316(16):1715. doi: 10.1001/jama.2016.13849. JAMA. 2016. PMID: 27784086 No abstract available.
Colorectal Cancer Screening Recommendations.
Mergener K, Potter NT. Mergener K, et al. JAMA. 2016 Oct 25;316(16):1716. doi: 10.1001/jama.2016.14915. JAMA. 2016. PMID: 27784087 No abstract available.
Colorectal Cancer Screening Recommendations.
Levine P, Gould-Suarez M. Levine P, et al. JAMA. 2016 Oct 25;316(16):1715-1716. doi: 10.1001/jama.2016.14918. JAMA. 2016. PMID: 27784088 No abstract available.

Summary for patients in

JAMA PATIENT PAGE. Screening for Colorectal Cancer.
Jin J. Jin J. JAMA. 2016 Jun 21;315(23):2635. doi: 10.1001/jama.2016.7569. JAMA. 2016. PMID: 27305107 No abstract available.