Colorectal Cancer Screening (ACG, 2021)

American College of Gastroenterology

These are some of the highlights of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

April 01, 2021

Updated guidelines on colorectal cancer (CRC) screening were published in March 2021 by the American College of Gastroenterology (ACG) in the American Journal of Gastroenterology.[1]

In average-risk individuals ages 50 to 75 years, CRC screening is recommended, to reduce the incidence of advanced adenoma, CRC, and mortality from CRC.

In average-risk individuals ages 45 to 49 years, CRC screening is suggested, to reduce the incidence of advanced adenoma, CRC, and mortality from CRC.

Continuation of screening beyond age 75 years may be considered, on an individualized basis.

Colonoscopy and fecal immunochemical testing (FIT) are recommended as the primary modalities for CRC screening.

The following screening tests may be considered for individuals unable or unwilling to undergo colonoscopy or FIT:

  • Flexible sigmoidoscopy

  • Multitarget stool DNA test

  • Computed tomography (CT) colonography or colon capsule

The ACG suggests against using Septin 9 for CRC screening.

For more information, please go to Colon Cancer, Rectal Cancer, and Colorectal Cancer Guidelines.


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