Practice Guideline
. 2021 May 18;325(19):1965-1977. doi: 10.1001/jama.2021.6238. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement Karina W Davidson 1 , Michael J Barry 2 , Carol M Mangione 3 , Michael Cabana 4 , Aaron B Caughey 5 , Esa M Davis 6 , Katrina E Donahue 7 , Chyke A Doubeni 8 , Alex H Krist 9 10 , Martha Kubik 11 , Li Li 12 , Gbenga Ogedegbe 13 , Douglas K Owens 14 , Lori Pbert 15 , Michael Silverstein 16 , James Stevermer 17 , Chien-Wen Tseng 18 19 , John B Wong 20Affiliations
AffiliationsItem in Clipboard
Practice Guideline
Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation StatementUS Preventive Services Task Force et al. JAMA. 2021.
. 2021 May 18;325(19):1965-1977. doi: 10.1001/jama.2021.6238. Authors US Preventive Services Task Force; Karina W Davidson 1 , Michael J Barry 2 , Carol M Mangione 3 , Michael Cabana 4 , Aaron B Caughey 5 , Esa M Davis 6 , Katrina E Donahue 7 , Chyke A Doubeni 8 , Alex H Krist 9 10 , Martha Kubik 11 , Li Li 12 , Gbenga Ogedegbe 13 , Douglas K Owens 14 , Lori Pbert 15 , Michael Silverstein 16 , James Stevermer 17 , Chien-Wen Tseng 18 19 , John B Wong 20 AffiliationsItem in Clipboard
Erratum in[No authors listed] [No authors listed] JAMA. 2021 Aug 24;326(8):773. doi: 10.1001/jama.2021.12404. JAMA. 2021. PMID: 34427621 Free PMC article. No abstract available.
Importance: Colorectal cancer is the third leading cause of cancer death for both men and women, with an estimated 52 980 persons in the US projected to die of colorectal cancer in 2021. Colorectal cancer is most frequently diagnosed among persons aged 65 to 74 years. It is estimated that 10.5% of new colorectal cancer cases occur in persons younger than 50 years. Incidence of colorectal cancer (specifically adenocarcinoma) in adults aged 40 to 49 years has increased by almost 15% from 2000-2002 to 2014-2016. In 2016, 26% of eligible adults in the US had never been screened for colorectal cancer and in 2018, 31% were not up to date with screening.
Objective: To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for colorectal cancer in adults 40 years or older. The review also examined whether these findings varied by age, sex, or race/ethnicity. In addition, as in 2016, the USPSTF commissioned a report from the Cancer Intervention and Surveillance Modeling Network Colorectal Cancer Working Group to provide information from comparative modeling on how estimated life-years gained, colorectal cancer cases averted, and colorectal cancer deaths averted vary by different starting and stopping ages for various screening strategies.
Population: Asymptomatic adults 45 years or older at average risk of colorectal cancer (ie, no prior diagnosis of colorectal cancer, adenomatous polyps, or inflammatory bowel disease; no personal diagnosis or family history of known genetic disorders that predispose them to a high lifetime risk of colorectal cancer [such as Lynch syndrome or familial adenomatous polyposis]).
Evidence assessment: The USPSTF concludes with high certainty that screening for colorectal cancer in adults aged 50 to 75 years has substantial net benefit. The USPSTF concludes with moderate certainty that screening for colorectal cancer in adults aged 45 to 49 years has moderate net benefit. The USPSTF concludes with moderate certainty that screening for colorectal cancer in adults aged 76 to 85 years who have been previously screened has small net benefit. Adults who have never been screened for colorectal cancer are more likely to benefit.
Recommendation: The USPSTF recommends screening for colorectal cancer in all adults aged 50 to 75 years. (A recommendation) The USPSTF recommends screening for colorectal cancer in adults aged 45 to 49 years. (B recommendation) The USPSTF recommends that clinicians selectively offer screening for colorectal cancer in adults aged 76 to 85 years. Evidence indicates that the net benefit of screening all persons in this age group is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the patient's overall health, prior screening history, and preferences. (C recommendation).
Comment inNg K, May FP, Schrag D. Ng K, et al. JAMA. 2021 May 18;325(19):1943-1945. doi: 10.1001/jama.2021.4133. JAMA. 2021. PMID: 34003238 No abstract available.
Mehta SJ, Morris AM, Kupfer SS. Mehta SJ, et al. JAMA Netw Open. 2021 May 3;4(5):e2112593. doi: 10.1001/jamanetworkopen.2021.12593. JAMA Netw Open. 2021. PMID: 34003278 Free PMC article. No abstract available.
Brenner H, Hoffmeister M. Brenner H, et al. Nat Rev Gastroenterol Hepatol. 2021 Oct;18(10):677-678. doi: 10.1038/s41575-021-00494-6. Nat Rev Gastroenterol Hepatol. 2021. PMID: 34282305 No abstract available.
Haghighat S, Sussman DA, Deshpande A. Haghighat S, et al. JAMA. 2021 Oct 5;326(13):1328. doi: 10.1001/jama.2021.13466. JAMA. 2021. PMID: 34609459 No abstract available.
Jin J. Jin J. JAMA. 2021 May 18;325(19):2026. doi: 10.1001/jama.2021.6557. JAMA. 2021. PMID: 34003224 No abstract available.
US Preventive Services Task Force; Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW Jr, García FAR, Gillman MW, Harper DM, Kemper AR, Krist AH, Kurth AE, Landefeld CS, Mangione CM, Owens DK, Phillips WR, Phipps MG, Pignone MP, Siu AL. US Preventive Services Task Force, et al. JAMA. 2016 Jun 21;315(23):2564-2575. doi: 10.1001/jama.2016.5989. JAMA. 2016. PMID: 27304597
US Preventive Services Task Force; Grossman DC, Curry SJ, Owens DK, Bibbins-Domingo K, Caughey AB, Davidson KW, Doubeni CA, Ebell M, Epling JW Jr, Kemper AR, Krist AH, Kubik M, Landefeld CS, Mangione CM, Silverstein M, Simon MA, Siu AL, Tseng CW. US Preventive Services Task Force, et al. JAMA. 2018 May 8;319(18):1901-1913. doi: 10.1001/jama.2018.3710. JAMA. 2018. PMID: 29801017
Knudsen AB, Rutter CM, Peterse EFP, Lietz AP, Seguin CL, Meester RGS, Perdue LA, Lin JS, Siegel RL, Doria-Rose VP, Feuer EJ, Zauber AG, Kuntz KM, Lansdorp-Vogelaar I. Knudsen AB, et al. JAMA. 2021 May 18;325(19):1998-2011. doi: 10.1001/jama.2021.5746. JAMA. 2021. PMID: 34003219 Free PMC article.
US Preventive Services Task Force; Mangione CM, Barry MJ, Nicholson WK, Cabana M, Chelmow D, Coker TR, Davis EM, Donahue KE, Jaén CR, Kubik M, Li L, Ogedegbe G, Pbert L, Ruiz JM, Stevermer J, Wong JB. US Preventive Services Task Force, et al. JAMA. 2022 Aug 23;328(8):746-753. doi: 10.1001/jama.2022.13044. JAMA. 2022. PMID: 35997723 Review.
US Preventive Services Task Force; Mangione CM, Barry MJ, Nicholson WK, Cabana M, Chelmow D, Coker TR, Davis EM, Donahue KE, Doubeni CA, Jaén CR, Kubik M, Li L, Ogedegbe G, Pbert L, Ruiz JM, Stevermer J, Wong JB. US Preventive Services Task Force, et al. JAMA. 2022 Jun 21;327(23):2326-2333. doi: 10.1001/jama.2022.8970. JAMA. 2022. PMID: 35727271 Review.
Marzo-Castillejo M, Bartolomé-Moreno C, Bellas-Beceiro B, Melús-Palazón E, Vela-Vallespín C. Marzo-Castillejo M, et al. Aten Primaria. 2022 Oct;54 Suppl 1(Suppl 1):102440. doi: 10.1016/j.aprim.2022.102440. Aten Primaria. 2022. PMID: 36435580 Free PMC article. Spanish.
Sardari A, Usefi H. Sardari A, et al. PLoS One. 2023 Dec 22;18(12):e0290192. doi: 10.1371/journal.pone.0290192. eCollection 2023. PLoS One. 2023. PMID: 38134011 Free PMC article.
Ishibashi F, Shida D, Suzuki S, Nagai M, Mochida K, Morishita T. Ishibashi F, et al. Int J Colorectal Dis. 2022 Dec;37(12):2543-2546. doi: 10.1007/s00384-022-04270-z. Epub 2022 Nov 16. Int J Colorectal Dis. 2022. PMID: 36383225 Free PMC article.
DeYoreo M, Rutter CM, Lee SD. DeYoreo M, et al. Am J Epidemiol. 2023 Feb 1;192(2):230-236. doi: 10.1093/aje/kwac177. Am J Epidemiol. 2023. PMID: 36222654 Free PMC article.
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