New study challenges current age-based colorectal cancer screening guidelines

Colorectal cancer (CRC) is responsible for more than 50,000 deaths per year and is the third most fatal type of cancer in the US. The US Preventive Services Task Force (USPSTF) currently recommends that adults aged 45-75 years be screened for CRC. A recent US study, published in The American Journal of Gastroenterology by Liu and colleagues, takes current health status into consideration and presents evidence that challenges current age-based CRC screening guidelines to recommend a more personalized approach.

In the study by Liu and colleagues, behavioural data from adults not up-to-date with colorectal screening was obtained from the Centers for Disease Control and Prevention (CDC) National Health Interview Survey. A total of 25,888 community-dwelling adults aged 65-84 years were included in the study; the receipt of a CRC screening test in the past year was examined along with ten-year mortality risk (based on health status, comorbidities, and life expectancy). Ten-year mortality risk was evaluated across five quintiles, ranging from a 12% risk to a 79% risk of dying in the next ten years. According to study findings, the proportion of individuals with a screening test in the past year remained nearly the same, with an average screening uptake of 38% across the lowest to highest ten-year mortality risk categories. This demonstrates that screening practices did not change much based on a patient’s ten-year mortality risk, resulting in potential under-screening and/or over-screening. Based on these findings, a more personalised approach that considers life expectancy would ensure that both low and high-risk individuals are screened appropriately. 

In the US, GlobalData epidemiologists forecast that there will be nearly 140,000 diagnosed incident cases of CRC by the end of 2023 in adults aged 18 years and older. However, should screening recommendations change in the near future, the number of diagnosed incident cases may surpass current forecast estimates due to increased case identification. GlobalData epidemiologists suggest that additional research be conducted to further support, elaborate on, and replicate these study findings.