The American College of Gastroenterology (ACG) has released an updated clinical guideline for colorectal cancer (CRC) screening.

For those at average risk of developing CRC, the ACG still strongly recommends CRC screening from age 50 to 75 years. They also now suggest that CRC screening begin at age 45, due to the incidence of CRC doubling in those aged 20 to 49; this recommendation is consistent with a draft recommendation on colorectal cancer screening from the United States Preventive Services Task Force (USPSTF). The ACG strongly recommends colonoscopy every 10 years and annual fecal immunochemical testing (FIT) as primary CRC screening methods. For those unable or unwilling to undergo colonoscopy or FIT, the ACG suggests considering flexible sigmoidoscopy every 5 to 10 years, multitarget stool DNA test every 3 years, computed tomography colonography every 5 years, or capsule colonoscopy every 5 years. The ACG does not recommend Septin 9 methylated DNA testing for CRC screening.

The updated guideline also includes recommendations on CRC screening for those with a family history of CRC, genetic testing, use of low-dose aspirin for reducing CRC risk, and strategies to improve adherence to CRC screening.

Shaukat A, Kahi CJ, Burke CA, et al. ACG Clinical Guidelines: Colorectal Cancer Screening 2021. Am J Gastroenterol. 2021 Mar 1;116(3):458-479. Available at: click here. Accessed March 15, 2021.