Screening for colorectal cancer

US preventive services task force recommendation statement

Kirsten Bibbins-Domingo, David C. Grossman, Susan J. Curry, Karina W. Davidson, John W. Epling, Francisco A Garcia, Matthew W. Gillman, Diane M. Harper, Alex R. Kemper, Alex H. Krist, Ann E. Kurth, C. Seth Landefeld, Carol M. Mangione, Douglas K. Owens, William R. Phillips, Maureen G. Phipps, Michael P. Pignone, Albert L. Siu

Research output: Contribution to journalArticle

509 Citations (Scopus)

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).

Original languageEnglish (US)
Pages (from-to)2564-2575
Number of pages12
JournalJAMA - Journal of the American Medical Association
Volume315
Issue number23
DOIs
StatePublished - Jun 21 2016

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Advisory Committees
Colorectal Neoplasms
Guaiac
Adenomatous Polyps
Sigmoidoscopy
Occult Blood
Mortality
DNA
Health
Hematologic Tests
Colonoscopy
Adenoma
Cause of Death
History
Tomography
Incidence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Bibbins-Domingo, K., Grossman, D. C., Curry, S. J., Davidson, K. W., Epling, J. W., Garcia, F. A., ... Siu, A. L. (2016). Screening for colorectal cancer: US preventive services task force recommendation statement. JAMA - Journal of the American Medical Association, 315(23), 2564-2575. https://doi.org/10.1001/jama.2016.5989

Screening for colorectal cancer : US preventive services task force recommendation statement. / Bibbins-Domingo, Kirsten; Grossman, David C.; Curry, Susan J.; Davidson, Karina W.; Epling, John W.; Garcia, Francisco A; Gillman, Matthew W.; Harper, Diane M.; Kemper, Alex R.; Krist, Alex H.; Kurth, Ann E.; Landefeld, C. Seth; Mangione, Carol M.; Owens, Douglas K.; Phillips, William R.; Phipps, Maureen G.; Pignone, Michael P.; Siu, Albert L.

In: JAMA - Journal of the American Medical Association, Vol. 315, No. 23, 21.06.2016, p. 2564-2575.

Research output: Contribution to journalArticle

Bibbins-Domingo, K, Grossman, DC, Curry, SJ, Davidson, KW, Epling, JW, Garcia, FA, Gillman, MW, Harper, DM, Kemper, AR, Krist, AH, Kurth, AE, Landefeld, CS, Mangione, CM, Owens, DK, Phillips, WR, Phipps, MG, Pignone, MP & Siu, AL 2016, 'Screening for colorectal cancer: US preventive services task force recommendation statement', JAMA - Journal of the American Medical Association, vol. 315, no. 23, pp. 2564-2575. https://doi.org/10.1001/jama.2016.5989
Bibbins-Domingo, Kirsten ; Grossman, David C. ; Curry, Susan J. ; Davidson, Karina W. ; Epling, John W. ; Garcia, Francisco A ; Gillman, Matthew W. ; Harper, Diane M. ; Kemper, Alex R. ; Krist, Alex H. ; Kurth, Ann E. ; Landefeld, C. Seth ; Mangione, Carol M. ; Owens, Douglas K. ; Phillips, William R. ; Phipps, Maureen G. ; Pignone, Michael P. ; Siu, Albert L. / Screening for colorectal cancer : US preventive services task force recommendation statement. In: JAMA - Journal of the American Medical Association. 2016 ; Vol. 315, No. 23. pp. 2564-2575.
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