Case 9: Summary

CRC Screening Review:
Here’s a quick review of the most highly recommended CRC screening options and their appropriate screening intervals:

Screen Shot 2021-05-25 at 8.07.50 AM

Case Summary:

Colorectal cancer (CRC) is the second leading cause of cancer mortality and the third most common cancer in both men and women in the United States. Approximately half of CRC related deaths can be attributed to missed screening opportunities. Overall incidence and mortality rates have shown a steady decline of approximately 1.7% and 3.2%, respectively per year, driven by changes in risk factors, early detection through screening and removal of precancerous polyps; however, a notable increase in CRC incidence among 40-49-year-olds is now being seen. Hence, the ACG and USPSTF have updated their guidelines to begin screening at 45. Colonoscopy and FIT testing are the primary screening modalities for CRC screening. Unfortunately, data suggests that nearly one-third of screening eligible Americans remain unscreened. Awareness begins with us! Now that you have completed our case and familiarized yourselves with the updated guidelines, you have the ability to spread this knowledge and appropriately counsel your patients. Thank you for helping with our efforts.

Case authored by: Jaclyn Chesner MD and Bhavana Bhagya Rao MD


  1. Ladabaum U, Dominitz JA, Kahi C, Schoen RE. Strategies for colorectal cancer screening. Gastroenterology. 2020;158(2):418-432. 
  2. Ladabaum U, Mannalithara A, Meester RGS, Gupta S, Schoen RE. Cost-effectiveness and National Effects of Initiating Colorectal Cancer Screening for Average-risk Persons at Age 45 Years Instead of 50 Years. Gastroenterology. March 2019.
  3. Shaukat A, Kahi CJ, Burke CA, Rabeneck L, Sauer BG, Rex DK. ACG clinical guidelines: colorectal cancer screening 2021. Am J Gastroenterol. 2021;116(3):458-479. 
  4. US Preventive Services Task Force, Davidson KW, Barry MJ, et al. Screening for colorectal cancer. JAMA. 2021;325(19):1965.

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