Systematic Reviews
Copyright ©The Author(s) 2018.
World J Gastroenterol. Jan 7, 2018; 24(1): 124-138
Published online Jan 7, 2018. doi: 10.3748/wjg.v24.i1.124
Table 1 Summarized recommendations for colorectal cancer screening in average-risk individuals, published in North America between 2007 and 2017
ContinentCountry/associationPublication yearAgeScreening tests recommendedRecommendationNote
North AmericaUnited States: ACG2009≥ 50Preferred prevention test: Colonoscopy (10 yr). If not possible or refused by individual: FS (5-10 yr) - OR CTC (5 yr) OR detection testGrade 1B except for FS (2B) and CTC(1C)Screening starting at age 45 for African American population
Preferred detection test: FIT (1 yr). If not possible: Annual gFOBT (Hemoccult Sensa) OR- Fecal DNA testing (3 yr)FIT : Grade 1B
United States: ACP201550-75High sensitivity FOBT/FIT (1 year) OR FS (5 years) OR FOBT/FIT (3 yr) + FS (5 yr) OR colonoscopy (10 yr)-
≥ 75 and individuals whose life expectancy is estimated to less than 10 yearsScreening not recommended-
United States: USPSTF201650-75gFOBT/FIT (1 yr) OR FIT-DNA (1-3 yr) OR FS (10 yr) + FIT (1year) OR FS (5 yr) OR colonoscopy (10 yr) OR CT-colonoscopy (5 yr)Grade A recommendation
76-85Screening is considered an individual decision,Grade C recommendation
Canada: CTFPHC201650-59gFOBT/FIT (2 yr) OR FS (10 yr) OR defer until age 60Weak recommendation; moderate-quality evidenceColonoscopy not recommended for screening (weak recommendation; low-quality evidence), but could be discussed
60-74gFOBT/FIT (2 years) OR FS (10 yr)Strong recommendation; moderate-quality evidence
≥ 75Screening not recommended, but can be discussedWeak recommendation; low-quality evidence
United States: NCCN201750-75Colonoscopy (10 years) OR gFOBT/FIT (1 yr) OR Fecal DNA test (3 yr) OR FS (5-10 yr) (+/- gFOTB/FIT at year 3) OR CTC (5 yr)Category 2A except for annual gFOBT and FS every 5-10 years (which are category 1)FIT is identified as more sensitive than gFOBT
76-85Screening should be an individual decision, can be discussed
United States: US Multi-Society Task Force of Colorectal Cancer201750-75First-tier (preferred tests): Annual FIT OR colonoscopy (10 yr)Strong recommendation; moderate-quality evidenceScreening for African American starting at age 45 (weak recommendation; very-low-quality evidence)
Second-tier: CTC (5 yr) OR FIT-fecal DNA testing (3 yr) OR FS (5-10 yr)CTC and FIT-DNA : Strong recommendation; low-quality evidence
FS: Strong recommendation; high-quality evidence
Third-tier: Capsule colonoscopy (5 yr)Weak recommendation; low-quality evidence
76-85Screening should be considered for individuals without prior screeningWeak recommendation; low-quality evidence