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Colorectal Cancer Test Recommendations

Topic Overview

For people at an average risk for colorectal (colon) cancer

The U.S. Preventive Services Task Force (USPSTF) has the following advice for colorectal cancer testing:1

  • People ages 50 to 75 should have a fecal occult blood test (FOBT), sigmoidoscopy, or colonoscopy. Talk with your doctor about which test is best for you.
  • People who have a sigmoidoscopy every 5 years should also have a stool test (FOBT) at regular intervals.
  • Some people older than 75 may benefit from screening tests. Others may not. Talk to your doctor about testing for colon cancer after age 75.

The American Cancer Society (ACS), the American Gastroenterological Association (AGA), and the American College of Gastroenterologists (ACG) recommend routine testing for people age 50 and older who have a normal risk for colon cancer. People with a higher risk, such as those with a strong family history of colon cancer, may need to be tested sooner. Talk to your doctor about when you should be tested.

Colorectal cancer screening guidelines for people 50 and older at average risk
Test Frequency

Stool test,* such as the fecal occult blood test (FOBT), fecal immunochemical test (FIT), or the stool DNA test (sDNA)

Every year for FOBT and FIT

Every 5 years for sDNA

or

Sigmoidoscopy*

Every 5 years

or

Colonoscopy

Every 10 years

or

Computed tomographic colonography (CTC), also called a virtual colonoscopy

Every 5 years

*Others recommend combining a stool test with a sigmoidoscopy.

For people at an increased risk for colorectal cancer

Your doctor may recommend earlier or more frequent testing if you:

  • Already have been diagnosed with colorectal cancer.
  • Have a first-degree relative (parent, brother, sister, or child) with an adenomatous polyp or colorectal cancer.
  • Have had adenomatous polyps removed from your colon. This type of polyp is more likely to turn into cancer, but the risk is still very low.
  • Have inflammatory bowel disease, such as ulcerative colitis or Crohn's disease.
  • Have a rare inherited polyp syndrome, such as FAP or Lynch syndrome (HNPCC).
  • Have had radiation treatments to the abdomen or pelvis.

What to think about

Virtual colonoscopy uses X-rays and computers to take two- or three-dimensional pictures of the interior lining of your large intestine. It may be used as a test for people who do not have an increased risk for colon cancer or for people who cannot have a colonoscopy. For people who have an increased risk for colon cancer, conventional colonoscopy may be better because it permits tissue biopsies or polyp removal. Virtual colonoscopy is not widely available, and the cost may not be covered by insurance.

References

Citations

  1. U.S. Preventive Services Task Force (2008). Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm.

Other Works Consulted

  • Levin B, et al. (2008). Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: A joint guideline from the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA: A Cancer Journal for Clinicians, 58(3): 130–160.

Credits

By Healthwise Staff
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Specialist Medical Reviewer Arvydas D. Vanagunas, MD - Gastroenterology
Last Revised August 20, 2013

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