TUESDAY, May 18, 2021 — The U.S. Preventive Services Task Force (USPSTF) concludes with high certainty that screening for colorectal cancer (CRC) has substantial net benefit for adults aged 50 to 75 years, while there is moderate certainty that there is moderate net benefit for adults aged 45 to 49 years. These findings form the basis of a final recommendation statement published in the May 18 issue of the Journal of the American Medical Association.
Jennifer S. Lin, M.D., from the Kaiser Permanente Evidence-Based Practice Center in Portland, Oregon, and colleagues conducted a systematic review of the effectiveness, test accuracy, and harms of screening for CRC (33, 59, and 131 studies, respectively). The researchers found that the different options to screen for CRC reduce cancer mortality, with a different level of evidence for each. In a modeling study, Amy B. Knudsen, Ph.D., provided updated model-based estimates of the benefits, burden, and harms of CRC screening. The researchers found that lowering the age to begin screening from 50 to 45 years yielded 22 to 27 additional life-years gained (LYG), 161 to 784 additional colonoscopies, and 0.1 to 2.0 additional complications per 1,000 persons. The additional LYG from continuing screening after age 75 years were generally small.
Based on these findings, the USPSTF concluded with high certainty that in adults aged 50 to 75 years, CRC screening has substantial net benefit (A recommendation); in adults aged 45 to 49 years, the USPSTF concluded with moderate certainty that CRC screening has moderate net benefit (B recommendation). For adults aged 76 to 85 years who have previously been screened, the USPSTF concluded with moderate certainty that CRC screening has small net benefit (C recommendation).
“To encourage screening and help patients select the best test for them, we urge primary care clinicians to talk about the pros and cons of the various recommended options with their patients,” a task force member said in a statement.
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Posted: May 2021