The U.S. Preventive Services Task Force (USPSTF) now recommends that screening for colon cancer start at age 45, not 50. This proposal is not yet finalized, but if it still stands after four weeks of public comment, insurance companies will most likely have to cover the cost of screening for 45-year olds if they don’t already.
The New York Times notes that the recommendation is unusual for the task force, which has called for less screening rather than more in several other cases, like cervical cancer screening and mammograms. This makes sense: the task force’s job is to balance the risks against benefits of preventive health care, which depend on specifics of the procedures as well as a person’s age and other risk factors.
As we noted in our guide to preventing colon cancer, the disease has been striking people at younger ages than in the past—so 45 is the new 50, in a sense. The American Cancer Society has recommended beginning screening at 45 since their 2018 guidelines, and several societies have recommended that screening at 45 is especially important for Black Americans. The USPSTF doesn’t suggest different screening ages based on race, but they do note that screening is especially important if you’re Black:
Results from CISNET modeling did not support different screening strategies by race. The USPSTF recognizes the higher colorectal cancer incidence and mortality in Black adults and strongly encourages clinicians to ensure their Black patients receive recommended colorectal cancer screening, followup, and treatment. The USPSTF encourages the development of systems of care to ensure adults receive high-quality care across the continuum of screening and treatment, with special attention to Black communities experiencing worse health outcomes.
What screening is recommended?
Colon cancer screening can mean a colonoscopy, which should be done every 10 years, or stool-based tests, which are less invasive but need to be done more often, usually every year.
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The USPSTF’s draft recommendation includes a chart of the different screening types and how often each should be done. They give screening an “A” rating for people between 50 and 75 years old, and a “B” rating for people 45 to 49. Typically, anything with an A or B grade must be covered by insurance. If you are between 75 and 85, the task force says that you and your doctor should decide together if screening makes sense for you, and they do not give a recommendation for screening people over age 85.
