Understanding the Pros & Cons of Colonoscopies

The US Preventive Services Task Force (USPSTF) recommends that adults receive periodic colorectal cancer screening beginning at age 50 years. If you are still in your 40s but have a family history of colon cancer, well, good luck finding expert guidance. The USPSTF says, in essence, that it sure would be nice to have more data. The American College of Physicians (ACP) likewise counsels, “Clinicians should not screen for colorectal cancer in average-risk adults younger than 50 years.” Sounds reasonable enough. Screening carries risks that could swamp the potential benefits for average- or low-risk patients. But what about people younger than 50 years whose family history leaves them with an above-average risk? The ACP recommends “individualized risk assessment.” Translation: they don’t know either.