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    Home > Active Ingredient News > Digestive System Information > The latest recommendations for colorectal cancer screening by the US Preventive Services Task Force (USPSTF)

    The latest recommendations for colorectal cancer screening by the US Preventive Services Task Force (USPSTF)

    • Last Update: 2021-06-22
    • Source: Internet
    • Author: User
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    This article is from the NEJM Journal Watch (NEJM Journal Watch) Updated Recommendations for Colorectal Cancer Screening, the latest version of colorectal cancer screening recommendations.
    The author: Thomas L.
    Schwenk, MD, US Preventive Services Task Force (USPSTF) with moderate Deterministically, it is concluded that screening from the age of 45 has moderate benefits for patients at general risk.
    Organizer: US Preventive Services Task Force
    .

    Background The last time the USPSTF issued guidelines for colorectal cancer (CRC) screening for general risk patients was in 2016 (NEJM JW Gen Med Aug 1 2016 and JAMA 2016; 315:2564)
    .

    This time they updated their recommendations and added a new recommendation for young people (age range, 45 to 49 years old)
    .

    These guidelines apply to adults (age, ≥45 years old) who have a general risk of colorectal cancer (ie no history of colorectal cancer, adenomatous polyps, and inflammatory bowel disease; and no genetic susceptibility to colorectal cancer [such as Lynch Comprehensive Levy] personal history or family history)
    .

    The key recommendation is that the USPSTF concludes with a high degree of certainty that colorectal cancer screening has obvious benefits for middle-aged people (age range, 50 to 75 years) (Class A recommendation)
    .

    The USPSTF concluded with moderate certainty that screening is moderately beneficial for young people (age range, 45 to 49 years) (type B recommendation)
    .

    The USPSTF concluded with moderate certainty that screening has little benefit for older people (age range, 76 to 85 years old) who have previously been screened (type C recommendation)
    .

    People in this age range who have never been screened may benefit slightly
    .

    There is a lack of evidence for benefits in older patients (age ≥86 years), and the harm from screening may outweigh the long-term survival benefits
    .

    Changes The main change in this recommendation is the lowering of the starting age for colorectal cancer screening (45 years old)
    .

    The USPSTF has extensively evaluated various existing examination methods, including direct observation methods (ie, computed tomography [CT] colon imaging, colonoscopy, and flexible sigmoidoscopy), as well as stool detection methods (ie, high-sensitivity healing Lignin stool occult blood test [gFOBT], stool immunochemical test [FIT] and stool DNA test)
    .

    Currently, the only stool DNA test approved by the US FDA includes the FIT part (sDNA-FIT)
    .

    Based on the evidence evaluation and recommendations of the USPSTF, based on a complex model that balances harms and benefits, they recommend the following screening intervals
    .

    gFOBT or FIT: Once a year
    .

    sDNA-FIT: once every 1 to 3 years
    .

    CT colonography: once every 5 years
    .

    Flexible sigmoidoscopy: every 5 years, or every 10 years and FIT every year
    .

    Colonoscopy: once every 10 years
    .

    The USPSTF did not suggest that any of these detection methods is the most ideal or the most effective
    .

    Comment that lowering the age at which colorectal cancer screening begins is a major change in the CRC screening strategy; however, please note that the Type B recommendation is not as strong as the Type A recommendation for the age range of 50 to 75 years
    .

    This change is consistent with the latest guidelines of the American Cancer Society, which marked the 45-year-old age threshold as a “can” recommendation, and the 50-year-old age threshold as a “strong” recommendation (CA Cancer J Clin 2018; 68:250)
    .

    The implementation of this guide requires a lot of publicity and education for patients and clinicians
    .

    Commented article[1] US Preventive Services Task Force.
    Screening for colorectal cancer: US Preventive Services Task Force recommendation statement.
    JAMA 2021 May 18; 325:1965.
    (https://doi.
    org/10.
    1001/jama.
    2021.
    6238)[ 2] Lin JS et al.
    Screening for colorectal cancer: Updated evidence report and systematic review for the US Preventive Services Task Force.
    JAMA 2021 May 18; 325:1978.
    (https://doi.
    org/10.
    1001/jama.
    2021.
    4417) [3] Knudsen AB et al.
    Colorectal cancer screening: An updated modeling study for the US Preventive Services Task Force.
    JAMA 2021 May 18; 325:1998.
    (https://doi.
    org/10.
    1001/jama.
    2021.
    5746)NEJM Journal The NEJM Journal Watch is published by NEJM Group.
    Internationally renowned doctors are invited to comment on important papers in the medical field to help doctors understand and use the latest developments
    .

    "NEJM Frontiers of Medicine" is translated several times a week, published on the app and official website, and selected 2-3 articles are published on WeChat
    .

    Copyright information This article is translated, written or commissioned by "NEJM Frontiers in Medicine" jointly created by Jiahui Medical Research and Education Group (J-Med) and "New England Journal of Medicine" (NEJM)
    .

    The Chinese translation of the full text and the included diagrams are exclusively authorized by the NEJM Group
    .

    If you need to reprint, please leave a message or contact nejmqianyan@nejmqianyan.
    cn
    .

    Unauthorized translation is an infringement, and the copyright owner reserves the right to pursue legal liabilities
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