July 31, 2023

ACP Colorectal Cancer Screening Guidelines May Negate Screening Gains

Minority Communities May Be Particularly Impacted


The American College of Physicians (ACP) guidance against CT colonography use to screen for colorectal cancer (CRC) represents a step backward – particularly in underserved communities where screening rates are lower and CRC death rates are much higher. ACP’s guidance to start routine screening at age 50 rather than 45 as the American Cancer Society recommends may also hinder recent gains against the nation’s third leading cancer killer. About a third of those who should be screened for CRC can’t or won’t get a colonoscopy. We need more testing options – not fewer.

CT colonography (CTC) is an American Cancer Society and United States Preventive Services Task Force-recommended screening test. Landmark studies in the New England Journal of Medicine and elsewhere show CTC is less invasive than and comparably accurate to colonoscopy. Studies at the University of WisconsinNational (US) Military Medical Centers, and in Europe show that use of the virtual exam significantly boosts screening rates and lowers costs — which can allow more providers to offer screening and save more lives.

Colorectal cancer death rates are 47% higher in Black men and 34% higher in Black women. A study says 19% of the racial disparity in colorectal cancer deaths is due to less screening. Recent census data shows that more Black and Hispanic people are getting screened with CTC compared to whites. Denying access to a test that is increasing screening in at-risk communities is not helpful.

CT colonography is an accurate, safe, and minimally invasive test that does not require sedation, allows people to go back to their daily activities, and is a preferred option for many who otherwise may not be screened. Doctors should discuss CT colonography with their patients. For more information on virtual colonoscopy, go to RadiologyInfo.org/VirtualCT.