This piece aims to provide some insight into the new U.S. Preventive Services Task Force colorectal cancer screening guidelines and what they mean for health and health care.
What’s Happened? Earlier this week, the U.S. Preventive Services Task Force (USPSTF) released updated recommendations regarding screening for colorectal cancer.
The USPSTF…Who? The U.S. Preventive Services Task Force is an independent, voluntary panel of national experts from medicine and primary care who are focused on prevention and evidence-based medicine. The Task Force has existed for more than three decades. It has been convened and supported by the Agency for Healthcare Research and Quality (AHRQ) since 1998 and continues to make evidence-based recommendations about clinical preventive services and medications.
Why Are These New Recommendations Important? They present convincing evidence that screening for colon cancer reduces cancer mortality.
To put these recommendations into context, colorectal cancer is currently the second leading cause of cancer-related deaths in the United States; roughly 49,000 people are expected to die from it this year alone.
By studying evidence on the effectiveness of the various screening techniques (which include colonoscopies, multi-targeted stool DNA tests, and fecal immunochemical tests, among others), as well as their potential harms, members of the USPSTF found that “screening for colorectal cancer with several different methods can accurately detect early-stage colorectal cancer and adenomatous polyps,” therein allowing for early-stage treatment of patients.
When Should We Be Screened? When you turn 50.
The USPSTF recommends that screening for colorectal cancer begin at 50 years of age and continue until 75 years – and there’s a reason for using this specific age range.
According to USPSTF, the harms for screening during this age span is small and the benefits are “substantial.” The advantages of early detection of and intervention for colorectal cancer begins to decline after the age of 75; there is—at best—a moderate benefit to continue screening through the age of 85.
It’s also worth noting that Medicare already provides colon cancer screening without cost-sharing for Medicare beneficiaries, and therefore wouldn’t change with the new Task Force recommendation.
How Do These Guidelines Impact the Health and Health Care of Patients? They could save lives and money, for a start.
Despite the fact that colorectal cancer is among the leading causes of cancer-related deaths, around one-third of eligible individuals in the United States have never been screened for colorectal cancer.
USPSTF’s evidence shows that beginning screening for colorectal cancer at age 50 and continuing until 75 could markedly reduce the number of deaths resulting from colorectal cancer. At present, this effective preventive intervention is severely underutilized. It’s uptake by members of the American public could influence the tackling of colorectal cancer nationwide, proving itself a benefit in terms of lives and dollars saved.
Where Can I Learn More? The For The Media page on The JAMA Network, which contains a summary, a link to the full report (doi: 10.1001/jama.2016.5989, linked here), a video, and more, is a good place to start. The press release can be found here.
For a first-person perspective on the recommendations, read Michael Cannon’s “Ascertaining Costs and Benefits of Colonoscopy More Difficult Than the Procedure Itself” on JAMA Internal Medicine.