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Screening for Colorectal Cancer

The purpose of screening is early diagnosis and treatment. Screening tests are given to people without current symptoms, but who have risk factors for certain diseases or conditions.

Screening Guidelines

You and your doctor will talk about what screening tests you should have. Most guidelines suggest the following:

Average Risk

Screening is recommended starting at age 45. Screening may be done with stool based tests and visual exams:

Stool based tests—stool samples are checked for possible signs or symptoms of cancer.

  • Fecal immunochemical test (FIT) every year
  • High-sensitivity fecal occult blood test (FOBT) every year
  • FIT-DNA stool test with high sensitivity every 3 years

Visual tests-the doctor will be able to see the inner walls of the rectum and colon.

High Risk

Guidelines for those with sibling or parent that had colorectal cancer onset after age 60 include:

  • Begin screening at age 40
  • Colonoscopy every 10 years or more often based on findings

Guidelines for those with sibling or parent that had colorectal cancer onset before age 60 include:

  • Begin screening at age 40 or 10 years younger than age of diagnosis of the affected relative (whichever is first)
  • Colonoscopy every 5 years or more often based on findings

Screening test options listed above can also be used for those with high risk.

REFERENCES:

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 21, 2018. Accessed February 27, 2020.

Benson AP, Venook AB, Cederquist L, et al. Colon Cancer. Version 2.2017. In: National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology (NCCN Guidelines). NCCN 2017 Mar from NCCN website.

Colon cancer treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/colorectal/patient/colon-treatment-pdq#section/_135. Updated January 30, 2020. Accessed February 27, 2020.

Colorectal cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003096-pdf.pdf. Accessed February 27, 2020.

Colorectal cancer. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/colorectal-cancer. Updated January 22, 2020. Accessed February 27, 2020.

Glynne-Jones R, Wyrwicz L, Tiret E, et al. Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017 Jul 1;28.

Last reviewed December 2019 by Mohei Abouzied, MD