NYC’ Health Department Updates Colorectal Cancer Screening Age to 45

Under advice from the Citywide Colorectal Cancer Control Coalition (C5), the NYC Department of Health has updated its screening guidance to recommend that adults with an average risk of colorectal cancer (CRC) should begin screening at age 45. This announcement, which coincides with the National Colorectal Cancer Awareness Month in March, comes prior to the anticipated final recommendation from the U.S. Preventive Services Task Force (USPSTF), which currently remains in a draft form.

NYC’s screening recommendation advices the use of:

• Colonoscopy every 10 years OR
• Stool-based testing at required intervals, to be followed up with a colonoscopy in case of a positive stool test

Average risk adults are stratified based on the following characteristics:

• No personal or family history of CRC
• No personal or family history of adenomas or sessile serrated polyps
• No personal history of inflammatory bowel disease
• No personal history of genetic syndromes (e.g., familial adenomatous polyposis, other polyposis syndrome, Lynch syndrome)
• No other source of increased risk (e.g., cystic fibrosis, history of abdominopelvic radiation)

The guidance also points out that those at an increased risk—either due to personal or family history of polyps CRC—may need to be screened before age 45. A colonoscopy is recommended for those at a higher risk of developing CRC.

Adults with an increased risk are stratified based on the following characteristics:

• History of CRC
• History of adenoma, sessile serrated polyp (SSP), or certain hyperplastic polyps
• Inflammatory bowel disease
• Known or suspected genetic syndrome (e.g., familial adenomatous polyposis, other polyposis syndrome, Lynch syndrome)
• CRC, advanced adenoma, or advanced SSP in one first degree relative before 60 years of age
• CRC, advanced adenoma, or advanced SSP in two or more first degree relatives at any age
• CRC, advanced adenoma, or advanced SSP in one first degree relative 60 years of age or older

 Useful Resources for Providers and Patients

The department has developed several downloadable, and easy-to-follow resources for both health care providers and patients:

• Colon Cancer Screening Form
• CRC Screening Recommendations (provider version)

For the public/patients:

• Get Informed: Reduce Your Colon Cancer Risk
• Get Screened: Find Colon Cancer as Early as Possible

Information on screening tests:

• Colonoscopy Fact Sheet
• High-Sensitivity Guaiac-Based Fecal Occult Blood Test (HSGFOBT)
• Fecal Immunochemical Test (FIT)
• Multi-Target Stool DNA Test (FIT-DNA)

All the information sheets are available in multiple languages.