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AAFP still recommends colorectal cancer screening from age 50 to 75

Thu, 06/21/2018 - 10:58
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In accordance with the US Preventive Services Task Force (USPSTF), the American Academy of Family Physicians (AAFP) does not intend to change its recommendations for colorectal cancer screening based on the recent change in the American Cancer Society (ACS) guideline.

The ACS recently released an updated guideline recommending colorectal cancer screening starting at age 45 years for average-risk patients, in contrast to the USPSTF guideline, released June 2016, recommending screening from age 50 through 75 years. The ACS acknowledged that the recommendation on screening those aged 45 to 49 years is graded as a qualified recommendation, as it relies on use of modelling without clinical trial-based evidence.

The AAFP agrees with the USPSTF recommendation for screening patients at ages 50 to 75 years, and graded its recommendation B. In addition, the AAFP offered a preferential recommendation for specific screening tests: fecal immunochemical tests, flexible sigmoidoscopy, and colonoscopy.

The ACS "assumed that colon cancer in younger adults is similar to cancer that occurs in older adults, and that screening would have the same benefits and no additional harms," said Dr Jennifer Frost, medical director for the AAFP's Health of the Public and Science Division, said in a statement. "Individual family physicians, in conversation with their patients, will decide whether earlier screening is appropriate. The AAFP will review empirical evidence once it is available."

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