In a recent editorial in the journal Gastroenterology, Chyke A. Doubeni, MD, MPH, Chair of the Department of Family Medicine and Community Health at the Perelman School of Medicine and a PRC researcher, and Robert H. Fletcher, MD of Harvard Medical School, call for a reassessment of colorectal cancer screening guidelines.
“The accumulated evidence shows that the risk of a colorectal cancer diagnosis in patients associated with having a family history of the condition becomes progressively smaller with increasing age, as does the association between family history and death from colorectal cancer,” Doubeni said. “Current standards recommend aggressive screening until age 75 to 85, but now a growing body of evidence show that it is not necessary to continue to screen most older people with a family history that aggressively.”
In light of these findings, for patients over 55—particularly those 65 years and older—who have only one immediate family member with colorectal cancer, Doubeni advocates for screening as recommended for average risk individuals (colonoscopy every ten years or other recommended screening test such as fecal immunochemical test every year). Those with two or more first-degree relatives with the disease, he says, should continue to receive a colonoscopy more often until more evidence is available.