U.S. Task Force Makes It Official: Colorectal Cancer Screenings for Most Adults Should Start at Age 45

The leading U.S. panel of experts in medical guidance made it official today: Overall, people 45 to 75 years of age should be screened for colorectal cancer to reduce their risk of dying from this disease. Those who are at above-average risk should consult a physician and be screened at an even earlier age.

The U.S. Preventive Services Task Force (USPST) published its final guidance on colorectal cancer screenings after releasing a draft of the recommendation in October. Previously, the task force recommended that people aged 50 to 75 be regularly screened. The USPST’s updated position is now aligned with that of the American Cancer Society, which updated its recommendation in 2018 to say regular screenings should start at age 45.

Colorectal cancer is the third-leading cause of cancer deaths in the U.S. “Despite strong evidence that screening for colorectal cancer is effective, about a quarter of people ages 50 to 75 have never been screened,” the USPST said in a news release Tuesday.

“The USPSTF decision to support lowering the age of colon cancer screening to 45-years-old is an outstanding step in the fight against colon cancer,” said Louise Morrell, M.D., medical director of Lynn Cancer Institute at Boca Raton Regional Hospital. “It is the result of important and expansive research recognizing that colon cancer is occurring in a younger population.  It is also important because this is a tool that not only detects cancer, but truly prevents cancers by identifying colon polyps and actually removing the tissue that could become a cancer in the future. “

Rates of colorectal cancer in people younger than 50 have been increasing by about 2 percent a year. Consult with your primary care physician to determine if you are at average risk for colorectal cancer and when you should be screened.

The task force’s recommendation will hopefully inspire adults aged 45 and older to get screened, especially as the COVID-19 pandemic has kept many from adhering to vital health screenings, said Michael Zinner, M.D., CEO and executive medical director of Baptist Health’s Miami Cancer Institute.

“Delayed screenings due to COVID is a ticking time bomb with a ten-year fuse,” said Dr. Zinner. “We learned during the height of the pandemic, that colonoscopy screening was down 85 percent from baseline the year before. When that gets modeled out over time, the modeling says that in 10 years, we might predict an additional 4,000 deaths from colon cancer.”

The recommendation by the task force is for people of “average risk” who have no symptoms. It applies to asymptomatic people with no prior diagnosis of colorectal cancer, history of colon or rectal polyps or personal or family history of genetic disorders that put them at higher risk. The task force also recommended selective screenings among adults ages 76 to 85 years, based on a patient’s overall health, prior screening history and preferences.

Colorectal cancer, which includes bowel cancer, colon cancer, or rectal cancer, refers to any cancer that affects the colon and the rectum. The update from the task force should lead to more comprehensive coverage for colorectal cancer screenings by most private insurance plans, according to the USPST.

“Far too many people in the U.S. are not receiving this lifesaving preventive service,” says Task Force vice chair Michael Barry, M.D. “We hope that this new recommendation to screen people ages 45 to 49, coupled with our long-standing recommendation to screen people 50 to 75, will prevent more people from dying from colorectal cancer.”