Screening Guidelines for Colorectal Cancer
Regular checkup and
colon cancer screening is the best way to prevent colorectal cancer. Finding
and removing colon polyps can help prevent colon cancer.
Beginning in 1980, the American Cancer Society (ACS) first issued formal
guidelines for CRC screening in average-risk adults. Since then, the ACS has
periodically updated its CRC guidelines including adding recommendations for
high-risk individuals in 1997.
The removal of precancerous lesions (polyps) during colonoscopy, has been
shown to significantly reduce the chance of developing colorectal cancer.
Colon Cancer Screening for People at High Risk
People with the following risks should begin colon screening before age 50.
History of inflammatory bowel disease (Crohn’s disease or ulcerative
Close relatives who have had colorectal disease or polyps before age 60
Family history of familial adenomatous polyposis or hereditary non-polyposis
Specific recommendations for high-risk people are as follows:
People with history of multiple or large polyps
Colonoscopy at the time of initial polyp diagnosis
If 1-2 small adenonatous polyps with low grade abnormality, repeat in 5
If 3-10 adenomatous polyps or 1 adenomoatous polyp greater than 1
centimeter, repeat colonoscopy within three years after polyp removal
With certain types of polyps or with high grade abnormality, repeat
colonoscopy within three years
If normal, repeat again in five years
If more than 10 adenomatous polyps, repeat in less than 3 years
If polyps are permanently attached and not on a stem and are removed in
portions, repeat colonoscopy in 2-6 months to verify complete polyp removal
People who have had surgery for colorectal cancer
Colonoscopy within one year after surgery; if normal, repeat in three
years; if still normal, repeat in five years.
People with a family history
Colonoscopy at age 40 or 10 years before the age that the immediate
family member was diagnosed with cancer, whichever is earlier; if normal,
repeat every five years.
People with a family history of familial adenomatous polyposis
At age 10 to 12, annual flexible
If positive genetic test, colon removal should be considered because of
very high risk of colorectal cancer.
People with a family history of hereditary nonpolyposis colon cancer
Colonoscopy every one to two years, starting at age 20 to 25 or 10 years
before age that immediate family member had cancer, whichever is earlier
Genetic testing offered to first-degree family members
People with inflammatory bowel disease
Colonoscopy every one to two years, starting eight years after the start
of pancolitis (involvement or the entire colon) or 12-15 years after the
start of left-sided colitis
Dated 09 March 2015