Colorectal Cancer Screening No Longer Recommended for Those Older Than 50 Years

ACPM 2009: Colorectal Cancer Screening No Longer Recommended for Those Older Than 50 Years

February 17, 2009 (Los Angeles, California) — The US Preventive Services Task Force (USPSTF) no longer recommends colorectal cancer screening for everyone older than 50 years.

In an update of its 2002 recommendation, the USPSTF now recommends that adults aged 50 to 74 years be screened in 1 of the following ways: every year with high-sensitivity fecal occult blood testing (FOBT); every 10 years with colonoscopy; or every 5 years with flexible sigmoidoscopy plus interval high-sensitivity FOBT.

The recommendation has a rating of A, meaning that the task force urges the clinician to provide the service to eligible patients and that there is good evidence that the service improves health outcomes, with benefits substantially outweighing harms, said USPSTF scientific director Mary Barton, MD, who presented the update here at Preventive Medicine 2009: The Annual Meeting of the American College of Preventive Medicine.

The task force also recommended against routine screening of people aged 76 to 85 years, although individual patients might have considerations that support screening.

In 2002, the USPSTF recommended screening for everyone older than 50 years. That year, the task force also noted that there was insufficient evidence to recommend for or against using computed tomography colonography (CTC) as 1 of the screening modalities.

Since then, several new studies have been performed that clarify the value of screening. The task force evaluated these data using a review conducted by the Oregon Evidence-Based Practice Center, which analyses clinical studies that federal, state, and private agencies use in making policy and coverage decisions.