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
African Americans and people 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 more
information on screening tests for colon cancer, see:
-
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.
- Are an African American.
- 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
-
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
|
December 7, 2011 |
Last Revised:
December 7, 2011
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.