USPSTF proposes lowering colon screening age to 45

2020 10 28 23 49 6025 Colon Polyps 400

Colon cancer screening should begin at age 45 instead of 50, according to a draft proposal issued October 27 by the U.S. Preventive Services Task Force (USPSTF).

In its draft recommendation statement, the USPSTF concluded with "moderate certainty that the net benefit of screening for colorectal cancer in adults ages 45 to 49 years is moderate." The USPSTF gave a "B" grade to the quality of evidence backing the earlier screening age.

The USPSTF already recommends colorectal cancer screening between the ages of 50 and 75, and in the draft recommendation the group stated that it concluded with "high certainty" that the benefit of screening these individuals is "substantial."

The USPSTF said that its assessment of the net benefit of screening covered stool-based tests with high sensitivity, colonoscopy, CT colonography (CTC), and flexible sigmoidoscopy.

There were no studies reporting on screening's benefits specifically in people younger than 50, but some studies that found an association of fewer colorectal cancer deaths with screening colonoscopy and reduced colon cancer mortality with screening fecal occult blood tests included subjects younger than 50, the USPSTF noted. Statistical modeling suggests more life-years are gained and fewer colorectal cancer deaths occur when screening begins at age 45 instead of 50 years, the agency concluded.

The USPSTF said it would be taking comment on the draft recommendation on its website through November 23.

The document is a positive development for CT colonography, according to Dr. Judy Yee, who chairs the American College of Radiology's Colorectal Cancer Committee.

"They have kept CTC as a valid option and gave screening for 45- to 49-year-olds a B rating, which means less evidence to support but still requires payers to cover," she wrote in an email to

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