Task force recommends dropping starting age for colorectal cancer screening via CT colonography

The U.S. Preventative Services Task Force on Tuesday dropped the recommended screening age for colorectal cancer using CT and other methods, drawing praise from radiologists.

USPSTF now endorses checking for the disease beginning at age 45 rather than 50, while continuing to “strongly” support check-ins up to age 75. The independent advisory panel of experts in primary care and prevention additionally voiced support for stool-based and visualization tests, the latter of which includes virtual colonoscopy performed using computed tomography.

“Far too many people in the U.S. are not receiving this lifesaving preventive service,” task force Vice Chair Michael Barry, MD, said in a statement. “We hope that this new recommendation to screen people ages 45 to 49, coupled with our long-standing recommendation to screen people 50 to 75, will prevent more people from dying from colorectal cancer.”

The American College of Radiology called the decision a “step forward” in the battle against colorectal cancer. Under the Affordable Care Act, decreasing the starting screening age will mean “millions” more Americans will receive private insurance coverage for this “vital” test. However, the college wants the Centers for Medicare & Medicaid Services to go a step further.

“CT colonography is already an American Cancer Society-recommended screening test that is less invasive than and comparably accurate to standard colonoscopy, increases screening rates where offered in the United States and abroad, and lowers costs—which can allow more providers to offer screening,” Judy Yee, MD, chair of the ACR Colon Cancer Committee, said Tuesday. “Now Medicare must follow the USPSTF lead and cover beneficiaries for this lifesaving exam.”

USPSTF’s recommendations come following a recent “alarming” rise in colorectal cancer cases among people younger than 50. The move updates the group’s 2016 recommendations while aligning them with the American Cancer Society, which started advocating for screening at age 45 back in 2018. Individuals ages 76-85 should continue to selectively seek screening on an individualized basis, experts said.

For more on the changes, you can find USPSTF’s recommendation statement, a modeling study, evidence report and several accompanying pieces in JAMA.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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