Screening Recommendations for persons at “general population risk” (refers to persons of a certain age, who are not known to have any medical conditions, family history of cancer or specific exposures that would increase the risk of developing certain type/s of cancer above that of the general population)

Beginning at age 50 years

• screening colonoscopy every 10 years is recommended. This is the best method for directly inspecting the entire surface of the colon and rectum.
• for patients who opt not to complete colonoscopy, an alternative strategy is annual fecal occult blood testing (FOBT) plus flexible sigmoidoscopy every five (5) years. (Note: further evaluation for an abnormal FOBT or flexible sigmoidoscopy is colonoscopy.)

Surveillance Recommendations for persons at “Increased risk” * (see below for examples of "increased risk", these levels are variable; talk with your doctor)

• Beginning at age 40 years (or 10 years prior to age of earliest case of colorectal cancer in family)
• talk with your doctor about your family history of cancer and your overall health status
• discuss age at which colonoscopy needs to start and plan for on-going surveillance
• consider a consultation with a genetic counselor for risk assessment
• persons who have a mother, father or sibling who has been diagnosed with colorectal cancer, require a colonoscopy at age 40  years, or earlier, depending upon age of onset in the family
• persons at increased risk of colorectal cancer require colonoscopy, no other test may substitute
• consider involvement in a prevention trial

*Colorectal Cancer Risk Increased Among

• persons  who have a close relative (mother, father, brother, sister or child)  with cancer of the colon or rectum
• persons  who have a maternal or paternal relative (aunt/uncle, grandparent) with colorectal cancer, especially if diagnosed before age 50 years
• persons with a personal and/or family history of inherited conditions associated with colon cancer [e.g., hereditary non-polyposis colorectal cancer (HNPCC) and familial adenomatous polyposis (FAP)]
• families affected by cancers of the breast, ovary and/or colon & rectum among mothers/fathers, brothers/sisters, children, aunts/uncles and/or grandparents·personal history of colorectal cancer, ulcerative colitis or Crohn’s disease or known colorectal polyps