“The first and most significant change in our guidelines was a lowering of the initial screening age for average-risk individuals from 50 to 45. The second biggest change is to extend the surveillance period from what was 5 to 7 years to 10 years now for patients with only one to two small tubular adenomas.” 

—Reid M. Ness, MD, MPH

 

The NCCN Guidelines on Colorectal Cancer Screening reflect significant changes that will spare some patients unnecessary interventions and, in other cases, facilitate earlier detection of colorectal cancer. The updated recommendations were presented at the NCCN 2022 Annual Conference by Reid M. Ness, MD, MPH, Assistant Professor of Medicine at Vanderbilt-Ingram Cancer Center, Nashville.

The changes to the guidelines pertain primarily to the age at which screening is initiated and to surveillance intervals that are dependent on findings on the index colonoscopy. They include:

- For average-risk individuals, lowering the initial screening age from 50 to 45

- For persons with a first-degree relative with colorectal cancer, initiating colonoscopy beginning at age 40, or 10 years before the earliest diagnosis of colorectal cancer in the family, with surveillance at least every 5 years

- For adults whose first-degree relatives have had advanced adenomas or advanced sessile serrated polyps at any age, initiating screening at age 40, or 10 years before the earliest diagnosis of colorectal cancer in the family

- For persons with second- and third-degree relatives with colorectal cancer, initiating screening at 45, as their risk is comparable to persons with no adenomas

- For patients with one or two small tubular adenomas, extending the surveillance period from what was 5 to 7 years to 10 years now

- Shortening the time to the first surveillance exam to 6 months following resection of large adenomas or sessile serrated polyps that have unfavorable characteristics or were removed piecemeal

- Shortening the time to first surveillance to 1 year for patients found to have at least 10 adenomas or sessile serrated polyps at a single colonoscopy.

 

Read more: https://ascopost.com/issues/may-25-2022/nccn-clinical-practice-guidelines-in-oncology-2022-updates/