New national screening guidelines on colorectal cancer

Most Americans should get screened for colorectal cancer beginning at age 45 instead of age 50, according to new recommendations from the U.S. Preventive Services Task Force, which includes UVA Health's Li Li, MD, PhD, MPH.

This recommendation applies to Americans without symptoms who do not have a history of colorectal polyps or a personal or family health history of genetic disorders that increase the risk of colorectal cancer.

Colorectal cancer is the third-leading cause of cancer death in America, according to the Task Force, and an increasing number of cases are being diagnosed in younger Americans. The Task Force notes that colorectal cancer diagnoses among Americans ages 40 to 49 increased by almost 15% from 2000-02 to 2014-16. Black Panther star Chadwick Boseman was only 43 when he died of colon cancer in August.

With colorectal cancer diagnoses becoming more common among younger people and the latest science showing that it is beneficial to screen younger people, the Task Force determined that regular screenings should begin at age 45."

Li Li, MD, PhD, MPH, University of Virginia Health System

The updated recommendation also encourages all Americans ages 45 to 75 get screened, with some people continuing screening through age 85. The Task Force's report noted that "in 2016, 25.6% of eligible adults in the U.S. had never been screened for colorectal cancer, and in 2018, 31.2% were not up to date with screening."

"If detected early, colorectal cancer is very treatable, which highlights the importance of beginning your screenings at the appropriate age," Li said.

The Task Force recommends two types of screening strategies: direct visualization tests - such as colonoscopies - and stool-based tests. Patients should discuss their screening options with their healthcare provider.