The American College of Gastroenterologist's 2021 Colorectal Cancer Screening Guidelines

Colorectal cancer ranks third for both men and women as the most common cause of cancer death in the United States. Screening allows for removal of polyps before they turn to cancer or by identifying early-stage colorectal cancers, which are most treatable. The American College of Gastroenterology recently released an update of their 2009 recommendations, which includes average risk individuals between ages 45 and 49 years due to the increased incidence of early-onset colorectal cancers. They consider screening two types of screening options: (1) one-step colonoscopy, which is both diagnostic and therapeutic and (2) two-step options, all of which require a follow-up colonoscopy when the first step is positive. They added the recommendation of daily aspirin for some people aged 50 to 69 years. However, the recommendations for screening remain the same when people do take aspirin. They recommend endoscopists measure cecal intubation rates, adenoma detection rates, and withdrawal times to reduce postcolonoscopy cancers due to missed lesions. They also propose strategies to promote screening adherence and suggest health systems adopt them. These are important updates of which the gastroenterology nurse should be aware and assist with their implementation.