November 23, 2020
National Center for Health Research’s Comments on the United States Preventive Services Task Force’s Draft Recommendation Regarding Colorectal Cancer Screening in Asymptomatic Adults
We are writing to express our support for the United States Preventive Services Task Force’s (USPSTF) draft recommendation statement regarding colorectal cancer screening in asymptomatic adults.
The National Center for Health Research (NCHR) is a nonprofit think tank that conducts, analyzes, and scrutinizes research on a range of health issues, with a particular focus on which prevention strategies and treatments are most effective for which patients and consumers. We do not accept funding from companies that make products that are the subject of our work, so we have no conflicts of interest.
Colorectal cancer is the third leading cause of cancer-related deaths in the United States, and although its incidence and death rates have continued to drop, colorectal cancer cases and deaths among people younger than 55 have increased in recent years. We agree with the USPSTF that there is adequate evidence that screening asymptomatic adults ages 45 to 49 will reduce colorectal cancer mortality, and therefore support the USPSTF new grade “B” recommendation. Furthermore, given the evidence of substantial benefit in screening adults ages 50 and older, we support the recommendation of grade “A” in adults ages 50 to 75, and grade “C” recommendation in adults ages 76 to 85.
We also agree with the research needs and gaps identified by USPSTF. In particular, since Black adults have the highest incidence and mortality rates from colorectal cancer compared to other racial and ethnic groups, we agree that more research is needed to understand the factors contributing to the increased incidence and mortality. We concur that more studies are needed to compare the effectiveness and accuracy of different colorectal cancer screening strategies, both in general and in specific subgroups, such as Black adults and adults younger than 50 years. Lastly, in addition to addressing these gaps, we urge that future studies examine factors such as socioeconomic status and insurance coverage, which may contribute to access to screening and patient outcomes.
The National Center for Health Research can be reached at info@center4research.org or at (202) 223-4000.