The U.S. Preventive Services Task Force (USPSTF) has released a colon cancer screening guideline that lowers the starting age from 50 to 45. The guidance was published on May 18 in JAMA.
The new guidance updates the task force's previous 2016 recommendation and finalizes a draft recommendation it issued last October. In it, the USPSTF gives a "B" designation ("high certainty that net benefit is moderate to substantial") for colorectal cancer screening in adults between the ages of 45 and 49, and an "A" designation ("high certainty that net benefit is substantial") for adults between the ages of 50 and 75. Adults over 75 should consult with their clinician about regular colon cancer screening, the task force said.
Colon cancer screening is performed with stool-based tests but also with CT colonography (CTC), which through literature review the USPSTF found to have a sensitivity for lesions 10 mm or larger ranging from 89% to 95% and a specificity of 89%.
The American College of Radiology (ACR) lauded the new guidance.
"[This new] recommendation for such screening in adults 45 to 49 means that millions more Americans will receive private insurance coverage for this vital screening," said Dr. Judy Yee, chair of the ACR's colon cancer committee, in a statement released by the college. "Expanded coverage will help medical providers save more lives ... Now Medicare must follow the USPSTF lead and cover beneficiaries for this lifesaving exam."
![Axial images from unenhanced calcium score cardiac CT (left) and curved planar reformation images from CT angiography (right) show that higher long-term exposure to air pollution is associated with greater coronary artery calcium and more obstructive coronary artery disease (CAD). Top row: Images in a 68-year-old male patient with higher 10-year mean ambient air pollution exposure (7.9 μg/m3 for particulate matter measuring ≤2.5 μm in diameter [PM2.5] and 17.4 parts per billion [ppb] for NO2) with extensive CAD (coronary artery calcium score [CACS] >1,000 and obstructive CAD [≥70% diameter stenosis]). Bottom row: Images in a 57-year-old female patient with lower 10-year mean ambient air pollution exposure (6.3 μg/m3 for PM2.5 and 4.6 ppb for NO2) with no CAD (CACS = 0 and no obstructive stenosis).](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/06/hanneman.r6SMLzkezo.png?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
