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    Colorectal Cancer Screening

    Colorectal Cancer Screening

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    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: footnote 1

    • People ages 50 to 75 should have a stool test (FIT or FOBT), sigmoidoscopy, or colonoscopy.
    • People ages 76 to 85 should not be routinely screened for colorectal cancer. But there may be exceptions for some individuals.
    • People over age 85 should not be screened for colorectal cancer.
    • No recommendations are made about CT colonography (CTC, also called virtual colonoscopy) or the stool DNA test (sDNA).

    The American Cancer Society (ACS), the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology recommend routine testing for people age 50 and older who have a normal risk for colon cancer. They also have recommendations for other tests, such as virtual colonoscopy (CTC) and the stool DNA test (sDNA). footnote 2

    Talk with your doctor about which test is best for you.

    Experts agree that people with a higher risk, such as those who have 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 immunochemical test (FIT) or the fecal occult blood test (FOBT)

    Every year

    or

    Sigmoidoscopy

    Every 5 years*

    or

    Colonoscopy

    Every 10 years

    *Some experts recommend combining a stool test with a sigmoidoscopy.

    Less common screening tests include the stool DNA test (sDNA) and computed tomographic colonography (CTC).

    Colon Cancer: Which Screening Test Should I Have?

    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 computed tomography (CT) or magnetic resonance imaging (MRI) to make a three-dimensional image 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, regular 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.

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    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.
    2. 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.

    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

    ByHealthwise Staff
    Primary Medical Reviewer Adam Husney, MD - Family Medicine
    E. Gregory Thompson, MD - Internal Medicine
    Specialist Medical Reviewer Arvydas D. Vanagunas, MD - Gastroenterology

    Current as ofNovember 20, 2015

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