Colorectal Cancer Screening Starting at Age 45 Years—Ensuring Benefits Are Realized by All
Ce dossier présente les recommandations de l'"US Preventive Services Task Force" sur le dépistage du cancer colorectal
The latest recommendations from the US Preventive Services Task Force (USPSTF) represent a significant change in the scope of colorectal cancer (CRC) screening. For the first time, the USPSTF recommends initiating average-risk CRC screening at age 45 years, reduced from age 50 years in previous versions. This was a B statement, reflecting moderate certainty of moderate net benefit. The USPSTF continues to issue an A statement (reflecting high certainty of substantial net benefit) for screening adults aged 50 to 75 years. While other guidelines have recommended this younger age, the USPSTF guidelines directly inform insurance coverage and waiving of cost sharing as part of federal law. The new recommendation is based on a systematic review by Lin et al, recent epidemiology data from Siegel et al, and a modeling study by Knudsen et al, suggesting that the burden for CRC could be reduced at an acceptable burden of harms related to screening, which reflects both the established effectiveness of screening and the increase in incidence of early onset CRC (ie, diagnosis of CRC younger than age 50 years). In addition to the potential benefits of screening starting at age 45 years, an ancillary benefit could be an increase in screening rates among individuals aged 50 years and older.
JAMA Network Open , éditorial en libre accès, 2020