Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults

Publication Date: August 1, 2023
Last Updated: August 1, 2023

Summary of Recommendations

Clinicians should start screening for colorectal cancer in asymptomatic average-risk adults at age 50 years.
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Clinicians should consider not screening asymptomatic average-risk adults between the ages of 45 to 49 years. Clinicians should discuss the uncertainty around benefits and harms of screening in this population.
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Clinicians should stop screening for colorectal cancer in asymptomatic average-risk adults older than 75 years or in asymptomatic average-risk adults with a life expectancy of 10 years or less.
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Clinicians should select a screening test for colorectal cancer in consultation with their patient based on a discussion of benefits, harms, costs, availability, frequency, and patient values and preferences.
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Clinicians should select among a fecal immunochemical or high-sensitivity guaiac fecal occult blood test every 2 years, colonoscopy every 10 years, or flexible sigmoidoscopy every 10 years plus a fecal immunochemical test every 2 years as a screening test for colorectal cancer.
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Clinicians should not use stool DNA, computed tomography colonography, capsule endoscopy, urine, or serum screening tests for colorectal cancer.
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Recommendation Grading

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Overview

Title

Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults

Authoring Organization

Publication Month/Year

August 1, 2023

Last Updated Month/Year

August 8, 2023

Document Type

Guideline

Country of Publication

US

Document Objectives

The purpose of this updated guidance statement is to guide clinicians on screening for colorectal cancer (CRC) in asymptomatic average-risk adults. The intended audience is all clinicians. The population is asymptomatic adults at average risk for CRC.

Target Patient Population

Asymptomatic average-risk adults

Target Provider Population

Gastroenterologists, primary care providers, OBGYNs and other allied providers caring for adult patients.

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening

Diseases/Conditions (MeSH)

D015179 - Colorectal Neoplasms

Keywords

colorectal cancer, CRC, CRC Screening, colorectal cancer screening

Source Citation

Qaseem A, Harrod CS, Crandall CJ, Wilt TJ; Clinical Guidelines Committee of the American College of Physicians*. Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults: A Guidance Statement From the American College of Physicians (Version 2). Ann Intern Med. 2023 Aug 1. doi: 10.7326/M23-0779. Epub ahead of print. PMID: 37523709.

Supplemental Methodology Resources

Data Supplement

Methodology

Number of Source Documents
74
Literature Search Start Date
January 1, 2018
Literature Search End Date
April 1, 2023