Colorectal Cancer Screening Guidelines from the American College of Gastroenterology (ACG) and the U.S. Preventive Services Task Force (USPSTF)
Parameter | ACG Recommendation | USPSTF Recommendation |
|---|---|---|
Age | ||
Age 45 to 49 | Conditional recommendation to screen | Grade B recommendation to screen |
Age 50 to 75 | Strong recommendation to screen | Grade A recommendation to screen |
Age ≥ 75 | Conditional recommendation to screen | Grade C recommendation to screen, up to age 85 |
Test | ||
Colonoscopy | Every 10 years (preferred screening test) | Every 10 years* |
Fecal immunochemical test (FIT) | Every year (a first-line screening test) | FIT or high-sensitivity guaiac fecal occult blood test every year |
Flexible sigmoidoscopy | Every 5 to 10 years (alternative screening test) | Every 5 years (or every 10 years plus yearly FIT) |
Fecal DNA testing | Every 3 years (alternative screening test) | Every 1 to 3 years |
CT colonography | Every 5 years (alternative screening test) | Every 5 years |
Video capsule endoscopy | Every 5 years (alternative screening test) | No recommendation |
Septin 9 assay | Not recommended for screening | No recommendation |
* Colonoscopy is recommended if any of the other tests are abnormal; they do not replace colonoscopy entirely. | ||
Data from the ACG's 2021 clinical guidelines for colorectal cancer screening and the USPSTF's 2021 recommendation statement for screening for colorectal cancer. | ||