The Updated Guidelines for Colorectal Cancer Screening

By Grace Bellinger, NPHR Blog Editor

Two weeks ago today, the American Cancer Society released updated guidelines regarding colorectal cancer screening. Colorectal cancer (CRC) is the fourth most common type of cancer in the United States, with over 140,000 Americans expected to be diagnosed with CRC in 2018. It is also the second leading cause of death from cancer, with over 50,000 deaths each year.

Early detection of CRC or precursor lesions which may later turn into cancer has been shown to reduce incidence and mortality. For this reason, the American Cancer Society now recommends starting CRC screening at 45 years of age for those at average risk, rather than age 50.

The guidelines also include various screening options for those who are hesitant to undergo a colonoscopy, which involves a tiny camera investigating the entire colon. Based on patient preference, regular screening can be done using either a high-sensitivity stool-based test or a structural examination. However, all positive results using non-colonoscopy screening tests must be followed up with a colonoscopy soon thereafter.

Lastly, the new guidelines recommend continuing CRC screening through the age of 75 for adults at average risk that have a life expectancy of at least 10 years. Screening decisions can then be individualized based on patient preferences, life expectancy, and screening history from age 75 to 85, and is not necessary beyond the age of 85.

Check out the full guidelines for more information about screening options and the evidence behind the updated recommendations.


Wolf, A. M. D., Fontham, E. T. H., Church, T. R., Flowers, C. R., Guerra, C. E., LaMonte, S. J., … Smith, R. A. (2018). Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA: A Cancer Journal for Clinicians.

About NPHR Blog (339 Articles)
The is the blog of the Northwestern Public Health Review journal. The blog and journal are both student run and contain research articles, opinions, interviews and other content pertaining to public health.

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