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.
  • 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, should 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*

or

Sigmoidoscopy*

Every 5 years

or

Colonoscopy

Every 10 years

or

Computed tomographic colonography (CTC), also called a virtual colonoscopy

Possibly every 5 years

*One group recommends combining a stool test every 3 years with a sigmoidoscopy every 5 years.

Experts have not yet set guidelines for how often a person should have the stool DNA test.

For people at an increased risk for colorectal cancer

Some people may need to begin routine testing earlier than age 50 and have it more often. You may need 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. The American College of Gastroenterology recommends that African Americans start routine testing for colorectal cancer at age 45.
  • 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.
  • 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.

For more information, see the topics Colorectal Cancer and Colon Polyps.

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.ahrq.gov/clinic/uspstf/uspscolo.htm.

Credits

Author Debby Golonka, MPH
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Last Updated August 28, 2009

Last Updated: August 28, 2009

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