Screening Guidelines for Colorectal Cancer

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 RiskPeople with the following risks should begin colon screening before age 50.

History of inflammatory bowel disease (Crohn’s disease or ulcerative colitis)Close relatives who have had colorectal disease or polyps before age 60Family history of familial adenomatous polyposis or hereditary non-polyposis colon cancer

Specific recommendations for high-risk people are as follows:

People with history of multiple or large polypsColonoscopy at the time of initial polyp diagnosisIf 1-2 small adenonatous polyps with low grade abnormality, repeat in 5 years.If 3-10 adenomatous polyps or 1 adenomoatous polyp greater than 1 centimeter, repeat colonoscopy within three years after polyp removalWith certain types of polyps or with high grade abnormality, repeat colonoscopy within three yearsIf normal, repeat again in five yearsIf more than 10 adenomatous polyps, repeat in less than 3 yearsIf 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 historyColonoscopy 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 sigmoidoscopy.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 cancerColonoscopy every one to two years, starting at age 20 to 25 or 10 years before age that immediate family member had cancer, whichever is earlierGenetic 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


DisclaimerThe Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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