U.S. Preventive Services Task Force recomments colorectal cancer screening to begin at age 45, rather than 50 - May 2021
It’s official: The panel of national experts in prevention and evidence-based medicine known as the U.S. Preventive Services Task Force (USPSTF) now recommends colorectal cancer screening for Americans to begin at age 45, rather than at 50, as was previously the standard. The new recommendations, finalized and published on May 18th in the Journal of the American Medical Association, make an additional 21 million adults eligible for insurance-covered screening. Options include direct visualization tests such as colonoscopy, flexible sigmoidoscopy, or stool-based tests such as the FIT.
But who are the people making these recommendations? And how do they go about it? The USPSTF, established in 1984, is an all-volunteer panel of 16 primary care physicians and nurses from across the country. They span disciplines — from psychology to family medicine to internal medicine to obstetrics and gynecology — and work together to evaluate scientific research and come up with preventive screening recommendations to improve the health of Americans of all ages. “We have preventive therapy recommendations that really go from birth to death,” says Carol Mangione, MD, MSPH, chief of general internal medicine at the David Geffen School of Medicine and UCLA Health and vice chair of the USPSTF, of which she has been a member since 2016.
The task force was developed “with the notion that it would be primary care experts making recommendations that providers in primary care delivery could then follow,” she says. The group’s recommendations are based on the best evidence in scientific literature and aim to protect and improve the health of asymptomatic individuals."We are a panel of volunteers and we are independent of the U.S. government,” Dr. Mangione says. The USPSTF is also independent of any insurance company, though the passage of The Patient Protection and Affordable Care Act in 2010 requires the USPSTF’s screening recommendations to be covered benefits without out of pocket costs for patients by public and private health insurance.
“We actually do not consider insurance coverage or cost when we make our recommendations,” Dr. Mangione says. “Our recommendations are really grounded in trying to improve the health of all Americans by balancing the benefits versus the harms of any screening test, preventive medication, or behavioral treatment that we might be recommending.”
Prospective members of the task force are extensively vetted before being invited to join the group, she adds, to ensure they haven’t received large amounts of financial support from pharmaceutical or diagnostics companies for their past research or have other potential financial or intellectual conflicts of interest. Members of the USPSTF are all experienced researchers as well as primary care providers who use their expertise to evaluate scientific studies and develop timely health recommendations. They typically reassess these recommendations every five years or so. That interval can be shortened when new compelling scientific evidence arises. In the case of colorectal cancer screenings, “there were some important scientific papers that showed that there was a trend toward people getting colon cancer at younger ages, and there was also some evidence showing that Black persons are more likely to get colon cancer and are more likely to die from it,” Dr. Mangione says. “So with that new evidence, we started revising this topic a little bit sooner.”
The group last issued recommendations on colorectal cancer screening in 2016. It released its new draft guidelines in November, 2020, which were finalized in May, 2021. Once the task force examines all relevant research, it publishes a draft of recommendations which are open to public commentary. Every public comment is reviewed and considered prior to drafting the final recommendation, Dr. Mangione says. The group’s entire process is transparent, she says, adding, “I think the public providers really trust what the task force does.” Dr. Mangione says helping to guide primary care providers and serve as a voice for preventive public health through the USPSTF is a great honor.
“For somebody like me, who’s had a long career doing research, the U.S. Preventive Services Task Force recommendations are really right at that interface of clinical research, evidence and policy that affect care delivery to the public,” she says. “It's an incredible privilege to be working at that interface and to be using my experience to help contribute to a process that really tries to make very strong, well-grounded, evidence-based recommendations for our primary care providers and patients to follow.”
UCLA Health wins grand prize from National Colorectal Cancer Roundtable for colorectal cancer screening efforts during March’s Colorectal Cancer Awareness Month - March 2021
Award honors individuals and organizations making tremendous progress toward the goal to achieve colorectal cancer screening rates of 80% and higher despite challenges with COVID-19
The National Colorectal Cancer Roundtable (NCCRT), founded by the American Cancer Society (ACS) and the Centers for Disease Control and Prevention (CDC), is honoring UCLA Health as the Grand Prize winner of the 2021 80% In Every Community National Achievement Award, given in recognition of distinguished, ongoing efforts to increase colorectal cancer screening rates across the United States.
Colorectal cancer is one of the leading causes of cancer death in men and women, yet it can often be prevented or found at an early stage, when it’s small and may be easier to treat, with regular screening.
"Regular colorectal cancer screening is one of the most powerful tools for preventing colorectal cancer or finding it early," said Richard Wender, MD, Chair of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, and NCCRT chair. "Yet screening rates remain low in many communities and the COVID-19 pandemic has further challenged efforts to address inadequate screening. We are honored to recognize the dedication of these community leaders that are working tirelessly to increase the number of people that have access to life-saving colorectal cancer screening, especially in disproportionately affected groups."
80% in Every Community is an NCCRT initiative that works with community health centers, health plans, hospitals, health systems, employers, and others to reach 80% colorectal cancer screening rates nationally. More than 1,800 organizations have signed a pledge to make this goal a priority. The 80% In Every Community National Achievement Award includes one grand prize winner and five other honorees. Each receives a monetary award to be used to support continued efforts to increase screening for colorectal cancer.
UCLA receives four SCOPY Awards for 2019 colorectal cancer awareness campaign - October 2019
On behalf of UCLA Health, the Vatche & Tamar Manoukian Division of Digestive Diseases submitted three entries for the American College of Gastroenterology (ACG) 2019 SCOPY Awards in May. The ACG honored UCLA Health with not three but FOUR awards! ACG's SCOPY Award recognizes the achievements of ACG members in their community engagement, education and awareness efforts for colorectal cancer prevention. Awardees are featured in the 2019 SCOPY Awards Booklet and shared with the members of the College. Winners will also be honored during the SCOPY Award Ceremony & Workshop at the 2019 ACG Scientific Meeting in San Antonio, TX on October 27, 2019.
The success of our system-wide effort was the result of a partnership among administration, faculty, staff and researchers across the health care enterprise to effectively implement a focused action plan. Through the multiple layers of collaboration, the UCLA CRC campaign capitalized on current resources and leveraged existing expertise. We are thrilled to receive this recognition! Campaign champions included the members of the UCLA Colon Cancer Quality Workgroup, Edgar Corona, MPH (2018-19 GI quality scholar), and Sylvia Lopez, MPH.
Colorectal cancer screening campaign receives eHealthcare Leadership Award - October 2019
The eHealthcare Leadership Awards, which draw over 1,000 entries, exclusively recognizes the very best websites and digital communications of healthcare organizations. The inaugural UCLA Health Colorectal Cancer Screening Campaign, led by the Vatche and Tamar Manoukian Division of Digestive Diseases, was recognized with a gold award for best integrative campaign. Campaign members and the UCLA Health marketing team worked together to develop great content, build strong user engagement, and find creative and innovative ways to enhance the user experience across all our digital and social channels.