Updates in Screening Recommendations for Colorectal Cancer

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Reid M. Ness
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In the past 2 years, several significant changes have been made to the NCCN Guidelines for Colorectal Cancer (CRC) Screening. The age for initiation of screening average-risk adults has been lowered from age 50 to 45 years—without differentiation by age and race—and from age50 to 45 years for those with second- and third-degree relatives with CRC. For several groups, surveillance intervals have been changed. Patients with 1 or 2 low-risk adenomas at index colonoscopy, on the other hand, can now wait 10 years rather than 5 to 7 years between surveillance examinations. The first surveillance examination following resection of large adenomas or sessile serrated polyps (SSPs) with unfavorable-risk characteristics or that were removed piecemeal should now occur at 6 months. For patients with ≥10 adenomas and SSPs on a single colonoscopy, time to first surveillance was lowered to 1 year.

Disclosures: Dr. Ness has disclosed receiving grant/research support from Guardant Health.

Correspondence: Reid M. Ness, MD, MPH, Vanderbilt University, 1301 Medical Center Drive, Suite 1745B, Nashville, TN 37232. Email: reid.ness@vumc.org
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