U.S. Preventive Services Task Force (*)
Disclaimer: Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
Financial Support: The USPSTF is an independent, voluntary body. The U.S. Congress mandates that the Agency for Healthcare Research and Quality support the operations of the USPSTF.
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U.S. Preventive Services Task Force. Screening for Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2008;149:627-637. doi: 10.7326/0003-4819-149-9-200811040-00243
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Published: Ann Intern Med. 2008;149(9):627-637.
Update of the 2002 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for colorectal cancer.
To update its recommendation, the USPSTF commissioned 2 studies: 1) a targeted systematic evidence review on 4 selected questions relating to test characteristics and benefits and harms of screening technologies, and 2) a decision analytic modeling analysis using population modeling techniques to compare the expected health outcomes and resource requirements of available screening modalities when used in a programmatic way over time.
The USPSTF recommends screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonoscopy in adults, beginning at age 50 years and continuing until age 75 years. The risks and benefits of these screening methods vary. (A recommendation)
The USPSTF recommends against routine screening for colorectal cancer in adults 76 to 85 years of age. There may be considerations that support colorectal cancer screening in an individual patient. (C recommendation)
The USPSTF recommends against screening for colorectal cancer in adults older than age 85 years. (D recommendation)
The USPSTF concludes that the evidence is insufficient to assess the benefits and harms of computed tomographic colonography and fecal DNA testing as screening modalities for colorectal cancer. (I statement)
Screening for colorectal cancer: clinical summary of a U.S. Preventive Services Task Force (USPSTF) recommendation.
For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents, please go to www.preventiveservices.ahrq.gov. FOBT= fecal occult blood testing.
*These recommendations do not apply to individuals with specific inherited syndromes (the Lynch syndrome or familial adenomatous polyposis) or those with inflammatory bowel disease.
Table 1. What the U.S. Preventive Services Task Force Grades Mean and Suggestions for Practice
Table 2. U.S. Preventive Services Task Force Levels of Certainty Regarding Net Benefit
Do colorectal cancer screening programs have demonstrated benefit in reducing colorectal cancer mortality?
What is the efficacy of newer screening technologiesthe high-sensitivity guaiac fecal occult blood test, the fecal immunochemical test, the fecal DNA test, and CT colonography?
What is the effectiveness of optical colonoscopy and flexible sigmoidoscopy in community practice?
What are the harms of newer screening technologies and optical colonoscopy and flexible sigmoidoscopy in community practice?
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Gastroenterology/Hepatology, Hematology/Oncology, Guidelines, Cancer Screening/Prevention, Colonoscopy/Sigmoidoscopy.
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