AAFP Colorectal Cancer Screening Recommendations Differ from USPSTF

AAFP recommends fecal immunochemical tests, flexible sigmoidoscopy, colonoscopy
AAFP recommends fecal immunochemical tests, flexible sigmoidoscopy, colonoscopy

HealthDay News — The American Academy of Family Physicians (AAFP) has graded the recommendation for colorectal cancer screening as a B recommendation, in contrast to the U.S. Preventive Services Task Force (USPSTF) grade A recommendation.

The USPSTF found convincing evidence that supported screening for adults aged 50 to 75 years, resulting in a grade A recommendation. The AAFP agreed that screening should be recommended, but classified it as a B recommendation, and also offered different suggestions for recommended screening tests. Both the AAFP and USPSTF agreed that the decision to screen adults aged 76 to 85 years should be an individualized one (C recommendation), and they both recommended against screening adults older than age 85 years (D recommendation).

The AAFP felt that the evidence for the benefits and harms of fecal DNA testing and computed tomography colonography was too limited to recommend its widespread use. The AAFP recommended screening with fecal immunochemical tests, flexible sigmoidoscopy, or colonoscopy from ages 50 to 75 years; these tests were supported by the best evidence relating to benefits and potential harms.

"The subcommittee agreed that the benefits of colorectal cancer screening outweigh the harms, but there are still many unanswered questions about both the benefits and harms, so the recommendation was downgraded to a 'B' grade," Jennifer Frost, MD, medical director for the AAFP Health of the Public and Science Division, said in a statement.

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