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Task Force finds several methods equally effective for colorectal cancer screening

In a change from its previous recommendation, the U.S. Preventive Services Task Force (Task Force) now recommends that adults age 50 to 75 be screened for colorectal cancer using annual high-sensitivity fecal occult blood testing, sigmoidoscopy every 5 years with fecal occult testing between sigmoidoscopic exams, or colonoscopy every 10 years. According to the Task Force, good evidence exists that using these methods save lives.

The Task Force recommends against routine colorectal cancer screening in adults between the ages of 76 and 85 because the benefits of regular screening were small compared with the risks. The Task Force also recommends that adults over the age of 85 not be screened at all because the harms of screening may be significant, and other conditions may be more likely to affect their health or well-being.

For people of all ages, the Task Force found insufficient evidence to assess the benefits and harms of computed tomographic (CT) colonography and fecal DNA testing as screening methods for the disease. Further, these Task Force recommendations do not apply to people with a personal history of certain types of polyps who are being monitored regularly for the condition or to those who have a family history of rare syndromes that increase a person's chances of getting colon cancer.

This recommendation strengthens the Task Force's previous position in 2002, when it recommended screening for colorectal cancer but noted that evidence was insufficient to recommend one screening method over another. This is also the first time that the Task Force has indicated an age that people should stop being screened for colorectal cancer.

The Task Force is the leading independent panel of experts in prevention and primary care. The Task Force, which is supported by the Agency for Healthcare Research and Quality (AHRQ), conducts rigorous, impartial assessments of the scientific evidence for the effectiveness of a broad range of clinical preventive services, including screening, counseling, and preventive medications. Its recommendations are considered the gold standard for clinical preventive services. The Task Force based its conclusions on a report from a research team led by Evelyn Whitlock, M.D., at the Kaiser Permanente Center for Health Research, which is part of AHRQ's Oregon Evidence-based Practice Center.

The recommendation and the accompanying summary of evidence are posted in the Annals of Internal Medicine online at http://www.annals.org/ and will appear in the November 4, 2008, print edition of the journal. The recommendations and materials for clinicians are also available on the AHRQ Web site at http://www.ahrq.gov/clinic/uspstf/uspscolo.htm. Previous Task Force recommendations, summaries of the evidence, and related materials are available from the AHRQ Publications Clearinghouse.

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