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Screening for Colorectal Cancer
The purpose of screening is early diagnosis and treatment. Screening tests are administered to people without current symptoms, but who have risk factors for certain diseases or conditions.
The decision to screen will likely be made on an individual basis based on your risk factors. Most guidelines suggest the following:
Since age is a risk factor, screening is recommended starting at age 50. Screening may be started earlier in African Americans and Native Americans because of higher risk. Screening may be done with one of the following:
- Colonoscopy every 10 years
- Sigmoidoscopy every 5 years
- Virtual colonoscopy (CT colonography) every 5 years—for those who cannot have scope procedure
- Barium enema every 5 years
- MR colonography every 5 years
- Stool DNA test every 3 years
- Annual Fecal occult blood test (FOBT)
- Annual fecal immunochemical test (FIT)
Recommendations for those with a first-degree relative with onset of colorectal cancer after age 60 include:
- Begin screening at age 40
- Preferred screening—colonoscopy every 10 years or more frequently, depending on the colonoscopy findings
Recommendations for those with a first-degree relative with onset of colorectal cancer before age 60 include:
- Begin screening at age 40 or 10 years younger than age of diagnosis of the affected relative (whichever is first)
- Preferred screening—colonoscopy every 5 years or more frequently, depending on the colonoscopy findings
Screening test options listed above can also be used for those with high risk.
American Cancer Society recommendations for colorectal cancer early detection. American Cancer Society website. Available at: http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-acs-recommendations. Updated February 5, 2015. Accessed December 3, 2015.
Colorectal cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gastrointestinal-disorders/tumors-of-the-gi-tract/colorectal-cancer. Updated July 2014. Accessed December 3, 2015.
Colorectal cancer screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 21, 2015. Accessed December 3, 2015.
Colorectal cancer screening. National Cancer Institute website. Available at: http://www.cancer.gov/types/colorectal/patient/colorectal-screening-pdq. Updated July 23, 2015. Accessed December 3, 2015.
4/8/2014 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Yee J, Kim DH, Rosen MP, et al. Colorectal cancer screening. American College of Radiology (ACR) Appropriateness Criteria. Available at: https://acsearch.acr.org/docs/69469/Narrative. Updated 2013. Accessed December 3, 2015.
- Reviewer: Mohei Abouzied, MD
- Review Date: 06/2016
- Update Date: 12/03/2015