The guidelines for colon cancer screening are vitally important for preventing deaths. Yet only 1 out of 5 (just 20% of) doctors follow current colon cancer screening guidelines for their patients. Educate yourself on which guidelines apply to you.
Colon cancer screening guidelines differ, depending on an individual's risk for developing the disease. The American Cancer Society recommends the following:
First, consider your personal risk for colon cancer. Are you at average or high risk? How do you know?
You are at average risk if all of the following are true for you:
- You have no family history of the disease.
- You have no personal history of colon polyps or adenomas or colon cancer.
- You have no personal history of inflammatory bowel disease, such as ulcerative colitis or Crohn's disease.
- There are no genetic conditions in your family that are linked to a higher colon cancer risk, such as hereditary nonpolyposis colorectal cancer (Lynch syndrome), familial adenomatous polyposis, juvenile polyposis or Peutz-Jeghers syndrome.
If you do not fall into any of the above categories, colon cancer screening should begin at age 50 for men and women. Acceptable strategies for screening for precancerous polyps and colon cancer include:
- Flexible sigmoidoscopy* every five years (sigmoidoscopy examines the lower part of the colon)
- Colonoscopy every 10 years (colonoscopy is the most complete test and examines the entire length of the colon)
- Double-contrast barium enema* once every five years
- CT colonoscopy (virtual colonoscopy)* once every five years
*If any of the marked tests are abnormal (shows a polyp or other growth) a full colonoscopy should be performed.
The above tests are preferred over the ones below, which can only detect colon cancer, not precancerous polyps:
- Fecal occult blood test (FOBT) or fecal immunochemical test every year
- Stool DNA test; recommended frequency varies, ask your doctor how often you may need this test
Colon Cancer Screening Guidelines for People at Higher Colon Cancer RiskIf you are at above average risk for colon cancer, you likely need to begin colon cancer screening earlier than age 50. You also may need to be screened more often than someone at average risk.
You have a higher-than-average risk for colon cancer if any of the following are true:
- You have a family history of colon cancer, particularly in a first-degree relative (parents, siblings, children), and especially if that relative was under age 50 at the time of diagnosis.
- You have a personal history of colon polyps or adenomas or colon cancer.
- You have a personal history of inflammatory bowel disease, such as ulcerative colitis or Crohn's disease.
- There are genetic conditions in your family that are linked to a higher colon cancer risk, such as hereditary nonpolyposis colorectal cancer (Lynch syndrome), familial adenomatous polyposis (FAP), juvenile polyposis (JP) and Peutz-Jeghers syndrome (PJS).
If any of these describe you, your first step is to talk with your doctor to determine which colon cancer screening schedule is best for you.
In addition to this, you should familiarize yourself with the detailed colon cancer screening recommendations for people at increased or high risk from the American Cancer Society. Keep in mind that the guidelines change as technology changes. Most gastroenterologists feel that a regular colonoscopy is still the best test for preventing colon cancer.
Yabroff, K. Robin; et al. "Are Physicians’ Recommendations For Colorectal Cancer Screening Guideline-Consistent?" J Gen Intern Med. 2011 February; 26(2): 177–184. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3019313/