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Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement.
JAMA 2016; 315(23):2564-2575JAMA

Abstract

IMPORTANCE

Colorectal cancer is the second leading cause of cancer death in the United States. In 2016, an estimated 134,000 persons will be diagnosed with the disease, and about 49,000 will die from it. Colorectal cancer is most frequently diagnosed among adults aged 65 to 74 years; the median age at death from colorectal cancer is 68 years.

OBJECTIVE

To update the 2008 US Preventive Services Task Force (USPSTF) recommendation on screening for colorectal cancer.

EVIDENCE REVIEW

The USPSTF reviewed the evidence on the effectiveness of screening with colonoscopy, flexible sigmoidoscopy, computed tomography colonography, the guaiac-based fecal occult blood test, the fecal immunochemical test, the multitargeted stool DNA test, and the methylated SEPT9 DNA test in reducing the incidence of and mortality from colorectal cancer or all-cause mortality; the harms of these screening tests; and the test performance characteristics of these tests for detecting adenomatous polyps, advanced adenomas based on size, or both, as well as colorectal cancer. The USPSTF also commissioned a comparative modeling study to provide information on optimal starting and stopping ages and screening intervals across the different available screening methods.

FINDINGS

The USPSTF concludes with high certainty that screening for colorectal cancer in average-risk, asymptomatic adults aged 50 to 75 years is of substantial net benefit. Multiple screening strategies are available to choose from, with different levels of evidence to support their effectiveness, as well as unique advantages and limitations, although there are no empirical data to demonstrate that any of the reviewed strategies provide a greater net benefit. Screening for colorectal cancer is a substantially underused preventive health strategy in the United States.

CONCLUSIONS AND RECOMMENDATIONS

The USPSTF recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years (A recommendation). The decision to screen for colorectal cancer in adults aged 76 to 85 years should be an individual one, taking into account the patient's overall health and prior screening history (C recommendation).

Authors+Show Affiliations

No affiliation info availableUniversity of California, San Francisco.Group Health Research Institute, Seattle, Washington.University of Iowa, Iowa City.Columbia University, New York, New York.State University of New York Upstate Medical University, Syracuse.Pima County Department of Health, Tucson, Arizona.Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.University of Louisville, Kentucky.Duke University, Durham, North Carolina.Fairfax Family Practice Residency, Fairfax, Virginia11Virginia Commonwealth University, Richmond.Yale University, New Haven, Connecticut.University of Alabama at Birmingham.University of California, Los Angeles.Veterans Affairs Palo Alto Health Care System, Palo Alto, California16Stanford University, Stanford, California.University of Washington, Seattle.Brown University, Providence, Rhode Island.University of North Carolina, Chapel Hill.Mount Sinai School of Medicine, New York, New York21James J. Peters Veterans Affairs Medical Center, Bronx, New York.

Pub Type(s)

Journal Article
Practice Guideline
Research Support, U.S. Gov't, P.H.S.
Video-Audio Media

Language

eng

PubMed ID

27304597

Citation

US Preventive Services Task Force, et al. "Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement." JAMA, vol. 315, no. 23, 2016, pp. 2564-2575.
US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;315(23):2564-2575.
Bibbins-Domingo, K., Grossman, D. C., Curry, S. J., Davidson, K. W., Epling, J. W., García, F. A. R., ... Siu, A. L. (2016). Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA, 315(23), pp. 2564-2575. doi:10.1001/jama.2016.5989.
US Preventive Services Task Force, et al. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2016 Jun 21;315(23):2564-2575. PubMed PMID: 27304597.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. AU - ,, AU - Bibbins-Domingo,Kirsten, AU - Grossman,David C, AU - Curry,Susan J, AU - Davidson,Karina W, AU - Epling,John W,Jr AU - García,Francisco A R, AU - Gillman,Matthew W, AU - Harper,Diane M, AU - Kemper,Alex R, AU - Krist,Alex H, AU - Kurth,Ann E, AU - Landefeld,C Seth, AU - Mangione,Carol M, AU - Owens,Douglas K, AU - Phillips,William R, AU - Phipps,Maureen G, AU - Pignone,Michael P, AU - Siu,Albert L, PY - 2016/6/16/entrez PY - 2016/6/16/pubmed PY - 2016/6/25/medline SP - 2564 EP - 2575 JF - JAMA JO - JAMA VL - 315 IS - 23 N2 - IMPORTANCE: Colorectal cancer is the second leading cause of cancer death in the United States. In 2016, an estimated 134,000 persons will be diagnosed with the disease, and about 49,000 will die from it. Colorectal cancer is most frequently diagnosed among adults aged 65 to 74 years; the median age at death from colorectal cancer is 68 years. OBJECTIVE: To update the 2008 US Preventive Services Task Force (USPSTF) recommendation on screening for colorectal cancer. EVIDENCE REVIEW: The USPSTF reviewed the evidence on the effectiveness of screening with colonoscopy, flexible sigmoidoscopy, computed tomography colonography, the guaiac-based fecal occult blood test, the fecal immunochemical test, the multitargeted stool DNA test, and the methylated SEPT9 DNA test in reducing the incidence of and mortality from colorectal cancer or all-cause mortality; the harms of these screening tests; and the test performance characteristics of these tests for detecting adenomatous polyps, advanced adenomas based on size, or both, as well as colorectal cancer. The USPSTF also commissioned a comparative modeling study to provide information on optimal starting and stopping ages and screening intervals across the different available screening methods. FINDINGS: The USPSTF concludes with high certainty that screening for colorectal cancer in average-risk, asymptomatic adults aged 50 to 75 years is of substantial net benefit. Multiple screening strategies are available to choose from, with different levels of evidence to support their effectiveness, as well as unique advantages and limitations, although there are no empirical data to demonstrate that any of the reviewed strategies provide a greater net benefit. Screening for colorectal cancer is a substantially underused preventive health strategy in the United States. CONCLUSIONS AND RECOMMENDATIONS: The USPSTF recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years (A recommendation). The decision to screen for colorectal cancer in adults aged 76 to 85 years should be an individual one, taking into account the patient's overall health and prior screening history (C recommendation). SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/27304597/full_citation L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2016.5989 DB - PRIME DP - Unbound Medicine ER -