Official AGA Colorectal Cancer Screening Guidelines Pocket Guide Flipbook.
Issue link: https://eguideline.guidelinecentral.com/i/954066
Diagnosis ➤ The U.S. Multi-Society Task Force (USMSTF) recommends that clinicians offer CRC screening beginning at age 50 (Strong; High Quality of Evidence). (See below for adjustments in recommended age for onset of screening based on race and family history.) ➤ The USMSTF suggests that sequential offers of screening tests, offering multiple screening options, and risk-stratified screening are all reasonable approaches to offering screening (Weak; Low Quality of Evidence). ➤ The USMSTF recommends colonoscopy every 10 years or annual FIT as first-tier options for screening average-risk persons for colorectal neoplasia (Strong; Moderate Quality of Evidence). ➤ The USMSTF recommends that physicians performing screening colonoscopy measure quality, including the adenoma detection rate (Strong; High Quality of Evidence). ➤ The USMSTF recommends that physicians performing FIT monitor quality (Strong; Low Quality of Evidence). The recommended quality measurements for FIT programs are detailed in a prior publication. ➤ The USMSTF recommends CT colonography every 5 years or FIT–fecal DNA every 3 years (Strong; Low Quality of Evidence) or flexible sigmoidoscopy every 5–10 years (Strong; High Quality of Evidence) in patients who refuse colonoscopy and FIT. ➤ The USMSTF suggests that capsule colonoscopy (if available) is an appropriate screening test when patients decline colonoscopy, FIT, FIT– fecal DNA, CT colonography, and flexible sigmoidoscopy (Weak; Low Quality of Evidence). ➤ The USMSTF suggests against Septin 9 for CRC screening (Weak; Low Quality of Evidence). ➤ The USMSTF recommends that screening begin in non–African American average-risk persons at age 50 years (Strong; Moderate Quality of Evidence). ➤ The USMSTF suggests that screening begin in African Americans at age 45 years (Weak; Very Low Quality of Evidence). ➤ The USMSTF recommends that adults age <50 years with colorectal bleeding symptoms (hematochezia, unexplained iron deficiency anemia, melena with a negative upper endoscopy) undergo colonoscopy or an evaluation sufficient to determine a bleeding cause, initiate treatment, and complete follow-up to determine resolution of bleeding (Strong; Moderate Quality of Evidence).