Table 2.

Summary of Included Recommendations for CRC Screening in Average-Risk Adults From Assessed Guidelines^*

Guideline, Year (Reference)	Age-Based Screening Recommendations	Screening Methods and Intervals
ACR, 2018 (3)	≥50 y: screen	CT colonography (usually appropriate): every 5 y Double-contrast barium enema radiography (may be appropriate): every 5 y MR colonography (may be appropriate): every 5 y
ACS, 2018 (6)	45–75 y (if good health and life expectancy ≥10 y): screen 76–85 y: individualize decision on the basis of patient preferences, life expectancy, health status, and screening history ≥85 y: discourage screening	FIT: annual HSgFOBT: annual Multitarget sDNA: every 3 y Colonoscopy: every 10 y CT colonography: every 5 y Flexible sigmoidoscopy: every 5 y
CTFPHC, 2016 (4)	50–74 y: screen ≥75 y: do not screen	FOBT (either gFOBT or FIT): every 2 y Flexible sigmoidoscopy: every 10 y Colonoscopy: not recommended as a CRC screening test
MSTF, 2017 (8)	≥50 y: screen ≥45 y (if African American): screen ≥75 y or life expectancy <10 y (if up to date on screening and have negative results on prior screening tests): consider not screening Individuals with no prior screening should be considered for screening up to age 85 y, depending on consideration of their age and comorbid conditions	Colonoscopy (tier 1): every 10 y FIT (tier 1): annual CT colonography (tier 2): every 5 y† FIT plus sDNA (tier 2): every 3 y Flexible sigmoidoscopy (tier 2): every 10 y Capsule colonoscopy (tier 3): every 5 y Septin 9: not recommended as a CRC screening test
SIGN, 2016 (7)	Population-based screening	Quantitative FIT set at a fecal hemoglobin concentration cutoff that is appropriate for investigative capacity; screening interval NA
USPSTF, 2016 (5)	50–75 y: screen 76–85 y: individualize decision, taking into account the patient’s overall health and screening history	gFOBT: annual FIT: annual FIT plus sDNA: every 1 to 3 y Colonoscopy: every 10 y CT colonography: every 5 y Flexible sigmoidoscopy: every 5 y Flexible sigmoidoscopy with FIT: flexible sigmoidoscopy every 10 y plus FIT every year

ACR = American College of Radiology; ACS = American Cancer Society; CRC = colorectal cancer; CT = computed tomography; CTFPHC = Canadian Task Force on Preventive Health Care; FIT = fecal immunochemical test; FOBT = fecal occult blood test; gFOBT = guaiac-based FOBT; HSgFOBT = high-sensitivity gFOBT; MR = magnetic resonance; MSTF = U.S. Multi-Society Task Force on Colorectal Cancer; NA = not available; sDNA = stool DNA panel; SIGN = Scottish Intercollegiate Guidelines Network; USPSTF = U.S. Preventive Services Task Force.

^*The Appendix (available at Annals.org) gives full recommendations and details about strength of the recommendations.

^†Tier 2 is for patients who decline colonoscopy and FIT, and tier 3 is for patients who decline tier 1 and 2 screening methods.