Contact: Aimee Frank
The U.S. Multi-Society Task Force (MSTF) on Colorectal Cancer represents AGA, ACG and ASGE. The MSTF issues recommendations on prevention of colorectal cancer and issued screening recommendations for colorectal cancer in 2017.
The MSTF has previously recommended that colorectal cancer screening for average-risk persons (persons who do not have a family history of colorectal cancer in a first-degree relative) begin at age 45 years in African Americans and age 50 in other groups. The MSTF has reviewed the recent recommendation from the American Cancer Society (ACS) to lower the age to begin screening from 50 to 45 years in all Americans. This change was a qualified recommendation based largely on a modeling study utilizing updated data on the incidence of colorectal cancer in younger people.
Evidence from screening studies to support lowering the screening age is very limited at this time. Based on the modeling study used to support the ACS recommendation, the MSTF recognizes that lowering the screening age to 45 may improve early detection and prevention of CRC. The MSTF expects the new ACS recommendation to stimulate investigation that will clarify the benefits and risks of earlier screening.
As the MSTF has previously noted and discussed, rates of colorectal cancer are increasing in Americans down to age 20 years. Beginning screening at 45 years addresses only part of the increasing risk of colorectal cancer in young persons. For all persons under 50 years, it remains critical to promptly assess symptoms consistent with colorectal cancer. In particular, rectal bleeding and unexplained iron deficiency anemia have substantial predictive value for colorectal cancer and should be thoroughly evaluated.
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ACG, AGA and ASGE are committed to collaborate on issues of common interest to all members of the GI community, including public policy and regulatory challenges facing gastroenterologists. This message is being sent as a joint communication from the three societies and has been reviewed by each organization.