USPSTF Releases Draft Language to Lower Colorectal Cancer Screening Age to 45


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Click to Read our update from November 23, 2020

Recent studies have demonstrated that colon and rectal cancers are on the rise for adults under the age of 50.  As a result, the United States Preventive Services Task Force (USPSTF) announced its intent to recommend that colorectal cancer (CRC) screenings begin at 45 years old for individuals at average risk. We need your support to make this draft recommendation final.

Read the letter to USPSTF

The United States Preventive Services Task Force (USPSTF) announced its intent to recommend that colorectal cancer (CRC) screenings begin at 45 years old for individuals at average risk. The majority of health insurance carriers in the United States will follow the USPSTF recommendation once finalized. This means that people age 45 and older will, in most cases, be eligible for insurance reimbursement for CRC screening. This recommendation lowers the USPSTF’s recommendation from 50 to 45, and aligns with the American Cancer Society’s 2018 recommendation that screening begin at age 45 based on an analysis published in the Journal of the National Cancer Institute. The recommendation is now in draft form and open for public comment. 

The United States Preventive Services Task Force (USPSTF) assigns one of five letter grades to each of their recommendations. The draft guidelines recommend CRC screening at age 45 at a B Grade, which means there is a high certainty of at least a moderate benefit for the service. The Task Force advises that clinical practices offer all services that have an A or B recommendation. 

What does this mean for patients?

It means it is required that private insurance plans subject to the Affordable Care Act (ACA) and Medicare plans provide coverage for the service without any co-pay or out-of-pocket costs to the patient. The CRC screening recommendations are still a draft. Insurance will not cover the change in guidelines until this is officially determined.

A group of leading CRC non-profits, including the Colorectal Cancer Alliance, Fight Colorectal Cancer, and the Colon Cancer Coalition, are celebrating this draft recommendation as a success for health advocacy, and see it as a necessary step forward to protect the well-being of Americans. This change reflects updated CRC evidence  particularly the upward trend in CRC diagnoses among people under age 50, known as young-onset or early-age-onset CRC. Alarmingly, the incidence of young-onset CRC has increased by 2% every year since 1990, with no end in sight. 

75% of all young-onset cases are diagnosed between ages 40-49. Furthermore, a recent study demonstrated a steep increase in CRC incidence between ages 49 and 50, with most cases diagnosed at an invasive stage among patients 50 years old, specifically. This suggests that these cancers were developing undetected for several years prior to the diagnosis at age 50.

“In addition to prevention, diagnosing some cancers at an earlier stage could potentially be associated with more favorable cost-benefit and resource allocation balances and should be taken into account when estimating the potential effects of a screening threshold at 45 years of age,” according to a 2020 study appearing in JAMA.

This draft recommendation will be finalized next year and will benefit thousands of younger individuals who were previously unable to afford this life-saving screening due to lack of coverage by insurance carriers. On-time CRC screening is cancer prevention. Delays in screening give cancer time to grow and metastasize, which drastically cuts survival rates, results in exorbitant treatment costs, and affects quality of life for patients and their caregivers. This creates financial strain for many, on top of the emotional toll of a cancer diagnosis. 

This disease often impacts people while at the height of their careers, building their families, and caring for older relatives. These are lives that need greater protection from CRC. Protection easily afforded through life-saving screening. 

For these reasons, we congratulate the USPSTF for updating its stance in response to the alarming growth of young-onset CRC. This change will fulfill the USPSTF organizational mission “to improve the health of all Americans by making evidence-based recommendations about clinical preventive services.” There is ample evidence to lower the screening age now. Lowering the recommended age for screening is supported by both the science and a moral obligation to save lives. Therefore, we applaud the USPSTF for its recommendation to reduce the age of screening for those at average risk of colorectal cancer to 45.

To all of the patients, survivors, and caregivers of young- or early-onset colorectal cancer, the Colorectal Cancer Alliance, Fight Colorectal Cancer and Colon Cancer Coalition recognize your experience is inextricably tied to this life-saving decision. Your journey and struggle with this disease has not been in vain.

Share your story with the USPSTF by November 23

As this is a draft recommendation, we urge you to share your story and voice your support for this new guidance directly to the USPSTF by November 23, when the comment period ends. All stories and comments shared here will be shared with the USPSTF at the close of the public comment period.

The comment period has closed. We received an overwhelmingly positive response from the colorectal cancer community, with nearly 1,600 signatures in support of this recommendation from patients, their loved ones, and medical professionals. These advocates also provided over 1,100 comments explaining why they support lowering the screening age to 45 for average-risk individuals. 

29 thoughts on “USPSTF Releases Draft Language to Lower Colorectal Cancer Screening Age to 45

  1. I am 49, just a few months shy of 50. My doctor went ahead and put in orders because I was close to that “magic” age, so I decided to go ahead and get my colonoscopy out of the way-had TOTALLY considered putting it off until sometime in my 50th year. To my utter shock and surprise, my doctor called last week to tell me 3 polyps were precancerous and 1 was cancerous. No family history, no symptoms, nothing. My case is a PERFECT EXAMPLE of why the screening age should be lowered. So, to “the powers that be”, I urge you to PLEASE do the right thing, help save lives and lower the age for CRC screenings. I am one of many who could’ve avoided a diagnosis of cancer.

  2. My late husband Harry was diagnosed with Stage 4 CRC at the age of 47. He died 3 years later. Had he been screened at 45, his cancer would have been diagnosed at a much earlier stage and he’d probably still be here to see his first grandson come into the world. The evidence is clear now that CRC is being diagnosed at younger ages and screening will make a difference. I urge USPSTF to do the right thing by lowering the screening age for average risk to at least 45.

  3. CRC tried to take me 4 yrs ago but I got lucky, Stage 1 Survivor! However, I should have been screened in my 40’s due to family history. Lowering the screening age will save lives, families, friends and cost our health care system LESS NOT MORE to cover this critical service. Spread the word and spread your cheeks!!

  4. Diagnosed AT 45 with right ascending stage 4 colon cancer with liver mets before I could ever ask for my screening. I had no classic symptoms. Just a lump…that went away before I got to the surgeon after the CT scan.
    6 months of chemo has left me with neuropathy. Complications from colectomy has left me with an iliostomy and now liver resection is up in the air. And sadly, resection doesn’t mean cure even if I get there. Between cancer, Covid and surgery I’ve missed work basically all of 2020 and I am the breadwinner and a healthcare provider. I have no personal or family history. Genetic testing negative. I have a family. A husband and 3 kids. I want to be around to watch them grow. Lowering to 45 is great!!! But it still misses a large subset of people!

  5. Colon cancer, Chemo, Ileostomies, catheters, PIK lines, months of Diarrhea, pooping your pants, fear of going too far from the house, permanent neuropathy in your hands and feet and wondering how much longer you will live are NO FUN. Trust me on this. So far it’s a 3-year chunk out of my life. Not to mention worrying that you may have passed it to your daughter and grandkids.

  6. My father died last November of rectal cancer, mom had uterine cancer at the same time, moms cancer has the characteristics of Lynch syndrome….I am 49 and due to moms cancer associated with DNA defect

  7. We desperately need to lower the recommended screening age for colorectal cancer to 45. I was diagnosed at age 28 with stage 4 colon cancer via admittance through the emergency room for what they thought was a burst appendix.

    My doctor insisted the only thing that was wrong with me was that I had bad gas from eating unhealthy after feeling the huge, painful, bulge on my right side. My doctor would not refer me to a gastro because I had no family history of colorectal cancer and because I was only 28.

    Lowering the screening age will hopefully send many physicians, and the general public, the message that all people are susceptible to colorectal cancer despite family history or lack thereof!

  8. Please lower the age for screening to age 45. As you know, by doing this will you will probably be saving many lives.

  9. I fully support earlier screening. Should be younger than 45 years old and as a standard not just for “at risk”, but this is a move in the right direction!

    1. We’re working on this problem. Please visit to sign if you are having issues.

    1. We’re working on this issue. Please visit to sign if you are having issues.

    1. Please be sure to enter your email address, first name, and last name in order to submit the form.

    1. Hi, Sarandon! If you saw the “thank you” page, your response was submitted. Please be sure to enter your email address, first name, and last name in order to submit the form.

    1. Hi, Rebecca! You must fill in the form and click submit. If you’re having issues, you can visit to go directly to the letter of support. Thank you!

  10. it is imperative to screen as early as possible – as a person that survived colon cancer at age 20 – I know from where I speak

    1. Thank you for your support! Please sign the letter and share your story if you haven’t already.

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