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Introduction Colorectal cancer (CRC) is the third most common cancer in the world, most commonly in people between 65 and 74 years old.
It is estimated that 10.
5% of new cases of CRC occur in people under the age of 50.
From 2000-2002 to 2014-2016, the incidence of CRC (especially adenocarcinoma) among adults aged 40-49 years increased by nearly 15%.
In 2016, 26% of adults in the United States had never been screened for CRC.
In 2018, the proportion rose again, with 31% of adults who had not received the latest screening.
In order to update its 2016 recommendations, the United States Preventive Medicine Task Force (USPSTF) commissioned a systematic review to assess the pros and cons of screening for CRC for asymptomatic adults 40 years and older.
Recently, the USPSTF published the latest guidelines for CRC screening on JAMA.
The main points of recommended CRC screening are as follows: All adults aged 50 to 75 should undergo CRC screening (recommendation level: A, significant clinical net benefit).
Age is one of the most important risk factors for CRC, and its incidence varies with age.
Increase and increase.
Currently, nearly 94% of new cases of CRC occur in adults over 45 years of age.
The USPSTF recommends that all adults between the ages of 50 and 75 should be screened for CRC.
CRC screening for adults aged 45 to 49 (recommendation grade: B, with medium clinical net benefit) Although the absolute risk of CRC for adults under 50 years old is much lower, it is for men and women with family history of CRC.
People with other risk factors (such as obesity, diabetes, long-term smoking, and alcoholism) should be screened regularly because of the higher risk of CRC.
At the same time, even without these risk factors, the USPSTF recommends that CRC screening should begin at the age of 45.
In addition, modeling conducted by the Cancer Intervention and Surveillance Modeling Network (CISNET) shows that compared with starting screening at the age of 50, starting CRC screening at the age of 45 can moderately increase the life span and reduce the incidence and mortality of CRC.
Doctors should selectively provide CRC screening for adults between 76 and 85 years old (recommendation grade: C, net clinical benefit is small).
There is evidence that the net benefit of screening this age group is very small.
The USPSTF recommends that when determining whether this screening is suitable for individual cases, selective screening should be performed based on the patient's health status (such as life expectancy, comorbidities), previous screening history, and personal preference.
With age, the hazards of colonoscopy (such as perforation and bleeding) and the dehydration or electrolyte imbalance that may be caused by CT colonography bowel preparation will increase, especially in the elderly.
Modeling studies estimate that, in general, among average-risk adults who have been properly screened before, very few people over the age of 75 will have an increase in life expectancy.
In the guidelines, the USPSTF further recommends the use of stool-based tests [including high-sensitivity guaiac test (gFOBT), immunochemical test (FIT), fecal DNA immunochemical test (sDNA-FIT)] and direct visual test (including colon Microscopy, CT colonography, sigmoidoscopy and sigmoidoscopy + FIT combined examination) are two screening methods for CRC screening.
The recommended intervals for CRC screening are as follows: High-sensitivity gFOBT or FIT once a year, sDNA-FIT once every 1-3 years, CT colonography every 5 years, sigmoidoscopy every 5 years, sigmoidoscopy every 10 years Inspection + FIT once a year.
Colonoscopy every 10 years.
The USPSTF recommends that patients, doctors and medical institutions follow the currently recommended screening intervals, follow-up examinations and treatment follow-up plans, and choose the most appropriate screening methods, which may improve patients’ expectations.
Acceptance and compliance of screening.Yimaitong compiled and compiled from: US Preventive Services Task Force.
Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement[J].
JAMA.
2021 May 18;325(19):1965–1977.
It is estimated that 10.
5% of new cases of CRC occur in people under the age of 50.
From 2000-2002 to 2014-2016, the incidence of CRC (especially adenocarcinoma) among adults aged 40-49 years increased by nearly 15%.
In 2016, 26% of adults in the United States had never been screened for CRC.
In 2018, the proportion rose again, with 31% of adults who had not received the latest screening.
In order to update its 2016 recommendations, the United States Preventive Medicine Task Force (USPSTF) commissioned a systematic review to assess the pros and cons of screening for CRC for asymptomatic adults 40 years and older.
Recently, the USPSTF published the latest guidelines for CRC screening on JAMA.
The main points of recommended CRC screening are as follows: All adults aged 50 to 75 should undergo CRC screening (recommendation level: A, significant clinical net benefit).
Age is one of the most important risk factors for CRC, and its incidence varies with age.
Increase and increase.
Currently, nearly 94% of new cases of CRC occur in adults over 45 years of age.
The USPSTF recommends that all adults between the ages of 50 and 75 should be screened for CRC.
CRC screening for adults aged 45 to 49 (recommendation grade: B, with medium clinical net benefit) Although the absolute risk of CRC for adults under 50 years old is much lower, it is for men and women with family history of CRC.
People with other risk factors (such as obesity, diabetes, long-term smoking, and alcoholism) should be screened regularly because of the higher risk of CRC.
At the same time, even without these risk factors, the USPSTF recommends that CRC screening should begin at the age of 45.
In addition, modeling conducted by the Cancer Intervention and Surveillance Modeling Network (CISNET) shows that compared with starting screening at the age of 50, starting CRC screening at the age of 45 can moderately increase the life span and reduce the incidence and mortality of CRC.
Doctors should selectively provide CRC screening for adults between 76 and 85 years old (recommendation grade: C, net clinical benefit is small).
There is evidence that the net benefit of screening this age group is very small.
The USPSTF recommends that when determining whether this screening is suitable for individual cases, selective screening should be performed based on the patient's health status (such as life expectancy, comorbidities), previous screening history, and personal preference.
With age, the hazards of colonoscopy (such as perforation and bleeding) and the dehydration or electrolyte imbalance that may be caused by CT colonography bowel preparation will increase, especially in the elderly.
Modeling studies estimate that, in general, among average-risk adults who have been properly screened before, very few people over the age of 75 will have an increase in life expectancy.
In the guidelines, the USPSTF further recommends the use of stool-based tests [including high-sensitivity guaiac test (gFOBT), immunochemical test (FIT), fecal DNA immunochemical test (sDNA-FIT)] and direct visual test (including colon Microscopy, CT colonography, sigmoidoscopy and sigmoidoscopy + FIT combined examination) are two screening methods for CRC screening.
The recommended intervals for CRC screening are as follows: High-sensitivity gFOBT or FIT once a year, sDNA-FIT once every 1-3 years, CT colonography every 5 years, sigmoidoscopy every 5 years, sigmoidoscopy every 10 years Inspection + FIT once a year.
Colonoscopy every 10 years.
The USPSTF recommends that patients, doctors and medical institutions follow the currently recommended screening intervals, follow-up examinations and treatment follow-up plans, and choose the most appropriate screening methods, which may improve patients’ expectations.
Acceptance and compliance of screening.Yimaitong compiled and compiled from: US Preventive Services Task Force.
Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement[J].
JAMA.
2021 May 18;325(19):1965–1977.
