The United States Preventive Services Task Force (USPSTF), an independent panel of health experts that offer recommendations for clinical preventive services, published on June 15 its final recommendation statement on screening for colorectal cancer. The experts found that “convincing evidence” supports screening adults aged 50 to 75.
For men and women aged 76 to 85, the USPSTF recommends screening on an individualized basis depending on the patient’s health and previous screening history – a “C” recommendation. Patients who have never been screened before, people who are healthy enough to undergo treatment in case cancer is found, and those who have no comorbid conditions that would significantly limit life expectancy will most likely benefit from screening.
In the United States, colorectal cancer is the second cause of death in men and women with cancer. It is estimated that, in 2016, 134,000 individuals will be diagnosed with colorectal cancer, and around 49,000 will die from it. Colorectal cancer is often found among adults aged 65 to 74 years.
Through different methods, the USPSTF stated that screening could detect early-stage colorectal cancer and adenomatous polyps.
“The task force strongly recommends screening adults ages 50-75 for colorectal cancer, as it reduces the risk of dying from the disease. Evidence convincingly shows screening for colorectal cancer works, but not enough people are taking advantage of this highly effective service.” said Albert Siu, M.D., M.S.P.H., immediate past chair of the task force in a news release.
Screening adults aged 50 to 75 can reduce the risk of mortality in colorectal cancer
According to USPSTF, screening colorectal cancer in men and women aged 50 ti 75 years can reduce the possibility of death in cancer patients. Although no screening strategies were considered more efficient than others, the task force says the test have different levels of effectiveness according to their strengths and limitations. Therefore, there is not a ranked order when it comes to the screening tests.
The task force goal is to encourage adult individuals to take screening test because it will have a significant impact on reducing colorectal cancer mortality.
Colorectal cancer is treatable when it is detected and removed at an early stage. The USPSTF states that the time between detection and treatment for this disease can be necessary to raise life expectancy in patients with colorectal cancer.
In the summary, it is said that screening for colorectal cancer in adults aged 50 to 75 are almost harmless. According to the experts, the only harm can be caused by the use of a colonoscopy.
Regarding patients, the task force also indicates that colorectal cancer is mostly found in adults older than 50 years. The median age at diagnosis is 68 years. The screening tests are mainly recommended for people having a family history of colorectal cancer.
The USPSTF also recommends screening for colorectal cancer for adults who do not have a family history of known genetic disorders or any indices that could predispose them to be diagnosed with colorectal cancer. For example, people with Lynch syndrome or familial adenomatous polyposis, with inflammatory bowel disease, previous adenomatous polyp, or previous colorectal cancer.
20 percent of colorectal cancer is linked to inherited familial syndromes. 3 to 10 percent of U.S population has a first-degree family member with colorectal cancer.
Although the task force did not review the evidence in populations with high colorectal cancer risk, other entities have recommended screening tests in patients at a younger age with a family history of colorectal cancer to be screen more often through colonoscopy.
The finding of the USPSTF found that male sex and black race are most likely to get colorectal cancer as well as running the risk of mortality. Compared with other racial/ethnic subgroups, black adults have the higher incidence. However, screening tests are recommended for all racial/ethnic groups.
No enough adults aged 50 to 75 are being screened, says CDC
According to researchers at The Centers for Disease Control and Prevention (CDC) 40 percent of adults aged 50-75 in the United Stated have been screened for colorectal cancer. Experts state that U.S. health facilities can test 80 percent of the population, but only half of men in women older 50 years have been screened. Indicated that around 15 million colonoscopies were performed in 2012.
According to the lead author of the paper, Djembe Joseph, MD, MPH and medical director of the colorectal cancer control program at CDC, since colorectal cancer is the “second leading cancer killer” in America, screening is a method that saves lives.
“The good news is that our modeling shows that the U.S. healthcare system has the potential to meet our national goal of screening 80 percent of adults ages 50-75. Ask your doctor about screening – there are several options now,” he added.