The U.S. Preventive Services Task Force (USPSTF) is calling for an end to colorectal cancer (CRC) screening for persons older than 85 years and is recommending against routine screening for those aged 76-85 years. This is the first time the USPSTF has indicated an age at which people should stop being screened for this disease.
According to the task force, persons older than 85 should not be screened at all for CRC because the harms of such testing may be significant and other conditions may be more likely to affect the health or well-being of these individuals. For adults aged 76-85 years, the benefits of regular screening are deemed “small” compared with the risks (Ann Intern Med. 2008;149:627-637).
The update also puts forth new preferences for CRC screening methods. After finding in 2002 that evidence was insufficient to recommend one approach over another, the USPSTF now asserts that adults aged 50-75 years should be screened using one of the following approaches: annual high-sensitivity fecal occult blood testing, sigmoidoscopy every five years with annual fecal occult testing in between, or colonoscopy every 10 years.
Screening may be especially important for people with metabolic syndrome, which appears to boost the risk of CRC, according to a report presented at the recent annual scientific meeting of the American College of Gastroenterology held in Orlando.
Two researchers from the Medical University of South Carolina in Charleston — internist Donald Garrow, MD, and gastroenterologist Mark Delegge, MD, drew their findings from information yielded annually by the National Health Interview Survey. The investigators analyzed data from approximately 350 individuals reporting a history of CRC and nearly 1,200 reporting a history of metabolic syndrome. They found that those with metabolic syndrome were 75% more likely to develop CRC at some point in their lifetime than those without.