The American College of Physicians has decided to stay with 50 years as the recommended age for initiating colorectal cancer screening in asymptomatic average-risk adults, according to new clinical guidance.
The guidance, published July 31 (Ann Intern Med August 2023. 176[8]:1092-1100), conflicts with guidelines from at least four specialty societies that have set the lower screening threshold at age 45—including the American Cancer Society (CA Cancer J Clin 2018;68:250-281), the U.S. Preventive Services Task Force (USPSTF) (JAMA 2021;325[19]:1965-1977) and the U.S. Multi-Society Task Force on Colorectal Cancer (USMSTF) (Gastroenterology 2021:162:285-299)—but is generally aligned with international guidelines (BMJ 2019;367:l5515; N Engl J Med 2018;378:1734-1740).
“The ACP guidance is disappointing,” said USMSTF co-author Aasma Shaukat, MD, MPH, the Robert M. and Mary H. Glickman Professor of Medicine and director of outcomes research in gastroenterology and hepatology at NYU Grossman School of Medicine, in New York City. “It undermines our effort to curb the rising incidence of CRC among individuals younger than 50. It also causes confusion among patients and payors, which detracts from our goal of achieving high screening uptake.”