Most adults should be screened for colorectal cancer. The age to begin screening, along with the risks and benefits of screen testing options, depends on a number of individual factors such as medical history and family history. You should discuss the timing and screening options that are best for you with your health care provider. If you have a family member such as a sibling, parent, or children who had colorectal cancer or a pre-malignant colon polyp, you will be advised to undergo screening no later than age 40. Please share this information with your provider.
Who is at increased risk of colorectal cancer?
Some people are considered to be at increased risk of colorectal cancer due to a personal or family history of cancer or certain types of pre-malignant colon polyps, known genetic mutations that are associated with colon cancer, or a personal history of inflammatory bowel disease.
Are you at average risk for colorectal cancer? If so, we recommend:
Start colon cancer screening at age 45 by the type of screening test that would work best for you; continue with regular colon cancer screening until age 75 as long as you are healthy.
For people ages 76-85, screening decisions should be based on personal preference, prior screening history, and overall health. Those over 85 most likely do not benefit from having routine screening.
Frequency of screening depends upon type of screening test used, the results of the previous testing, as well as family history.
Are you at increased risk for colorectal cancer?
Talk to your doctor about your risk factors, personal preferences, and whether a genetic evaluation would be appropriate for you. Review with your doctor if you have family members with colorectal, uterine, or other cancers.
Colonoscopy is the preferred screening method for those at increased risk. Talk to your doctor to determine the appropriate age to start screening based on your risk factors.
Frequency of screening should be based on your risk of developing colorectal cancer and results of any previous colonoscopy.
What tests are available through the Smilow Screening & Prevention Program?
Colonoscopy. An examination of the inside of the colon using a colonoscope inserted into the rectum. It is performed with sedation, so there is no pain during the procedure. The day prior includes a clear liquid diet, like broth and ginger ale, and laxatives.
A colonoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. Colonoscopy is not only an effective early detection tool, but it also is used to remove small growths or polyps before they have the chance to become a problem.
Frequency: For those with family history of colorectal cancer, it is recommended that they undergo a colonoscopy every 5 years. Once every 10 years for most people.
CT Colonography: This is a specialized CT scan used to evaluate the lining of the colon for growths or polyps. A bowel cleansing is required and a follow-up colonoscopy is recommended to remove any polyp detected during this test.
Frequency: Once every 5 years if negative.
Stool-Based Testing: Screening by stool testing is recommended for people at average risk of colorectal cancer. These tests can be done in the comfort of your home and don’t require changes in diet, medications, or a bowel prep. Stool-based testing isn’t recommended for those at increased risk for colorectal cancer, including patients with a personal history of polyps or cancers of the GI tract, a family history of colorectal cancer, known genetic risk factors, inflammatory bowel disease, or symptoms such as bleeding or anemia.
Fecal Immunochemical Test (FIT): This test checks stool for blood. It is important to know that a positive test will require the patient to undergo a colonoscopy to determine if cancer or an advanced polyp is present.
Frequency: Once every year, if negative.
Multi-targeted Stool DNA Test: This test checks stool for blood as well as certain DNA markers that are associated with colorectal cancer and polyps. It is important to know that a positive test will require the patient to undergo a colonoscopy to determine if cancer or an advanced polyp is present.