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Colon Cancer Screening

The following recommendations are for persons who have never had a colorectal cancer or pre-cancerous polyps (adenomatous type polyps). These are derived from the American College of Gastroenterology. You may visit the ACG website at acg.gi.org for more information.

Persons at Average Risk

Average risk persons are defined as age 50, a normal physical exam, absence of symptoms, absence of family history of colorectal cancer or colorectal polyps, and no evidence of microscopic blood within the stool (fecal occult blood test cards) on 3 sequential tests.

Recommendation: Colonoscopy every 10 years starting at age 50.
Alternative Strategy: Annual fecal occult blood tests (3) plus sigmoidoscopy every 5 yr.
NB: If annual fecal occult blood test cards are positive for blood, a colonoscopy should be performed regardless of the number of cards that are positive.

Moderately Increased Risk

Moderately increased risk persons are defined as those persons with one first-degree relative (mother, father, or sibling) with colorectal cancer diagnosed at age 60 or older.

Recommendation: Colonoscopy every 10 years starting at age 40.
Alternative Strategy: Annual fecal occult blood tests plus sigmoidoscopy every 5 yr.

High Risk Individuals

High-risk persons are defined as those persons with two or more first-degree relatives (mother, father or sibling) with colorectal cancer diagnosed at age less than 60.

Recommendation: Colonoscopy starting at age 40 or 10 years less than the youngest affected relative whichever is earlier.
Colonoscopy should be repeated every 3 to 5 years.
Alternative Strategy: No alternative screening modalities are considered adequate.