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Comparison of 2008 ACS/USMSTF/ACR Guidelines with those of the USPSTF


In March 2008, the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology released a consensus guideline (1) for colorectal cancer screening. In October 2008 the U.S. Preventive Services Task Force (2) also updated their screening recommendations.


As illustrated in the table below, these guidelines are more similar than different. The primary message from all of the involved organizations remains "Colorectal cancer screening saves lives; if you are 50 or older, choose a test and get screened."

Age to begin and end screening, and test prioritization

Recommendation

ACS/USMSTF/ACR

USPSTF

Age to begin and end screening in average risk adults

Begin and age 50, and end screening at a point where curative therapy would not be offered due to life-limiting co-morbidity

Begin screening at age 50. Routine screening between ages 76-85 is not recommended. Screening after age 85 is not recommended.

Screening in high risk adults

Detailed recommendations based on personal risk and family history

No specific recommendations for age to begin testing or type of testing

Prioritization of tests

Tests are grouped into those that (1) primarily are effective at detecting cancer, and (2) those that are effective at detecting cancer and adenomatous polyps. Group 2 is preferred over group 1 due to the greater potential for prevention.

No specific prioritization of tests, though recommendations acknowledge that direct visualization techniques offer substantial benefit over fecal tests

Stool Testing, Guaiac based FOBT (gFOBT)

Annual screening with high sensitivity guaiac based tests

Annual screening with high sensitivity guaiac based tests

Stool Testing, Immunochemical-based FOBT (FIT)

Annual screening

Annual screening

Stool Testing, Stool DNA (sDNA)

Screening every 3 years

Insufficient evidence to recommend for or against sDNA

Flexible Sigmoidoscopy

Screening every 5 years. Screening every 5 years, with annual gFOBT or FIT is an option

Screening every 5 years, with gFOBT every 3 years

Colonoscopy

Screening every 10 years

Screening every 10 years

CT Colonography

Screening every 5 years

Insufficient evidence to recommend for or against CT colonography

Double Contrast Barium Enema (DCBE)

Screening every 5 years

Not addressed

 

1- Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology Levin B, Lieberman D, McFarland B, et al. CA Cancer J Clin, May 2008; 58: 130 - 160

2- Screening for Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement U.S. Preventive Services Task Force; Annals of Internal Medicine 2008 149: 627-637


Last Revised: 10/31/2014