Happy 50th - Wishing You a Clear Colonoscopy

Colon cancer screenings should start at 40 for those with family history

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) It's a fairly well-known guideline. Start colorectal cancer screenings at age 50. Yet, far too many folks in this age group ignore these recommendations - a decision that can be deadly. Now these guidelines have been updated.

If you're not at high risk of colorectal cancer, start screenings at age 50.

If you are at high risk, screening should start at age 40, and if you have a family history, you should begin 10 years earlier than the age of your family member at the time of diagnosis. 

"Discuss your options for colorectal cancer screening with your doctor."

The American College of Physicians (ACP) has issued the new guidance statement regarding colorectal cancer, the second leading cause of cancer-related deaths in the United States.

A summary detailing the recommendations was published March 6, 2012 in the Annals of Internal Medicine, which is published by ACP. 

"Only about 60 percent of American adults aged 50 and older get screened, even though the effectiveness of colorectal cancer screening in reducing deaths is supported by the available evidence," said ACP President, Virginia L. Hood, MB.BS, M.P.H, F.A.C.P.

Colorectal cancer risk factors

If you are at high risk of the disease, you'll want to start screening at age 40. Colorectal cancer risk factors include:

  • Increasing age
  • Being African American; these individuals have the highest colorectal incidence and death rates in the United States
  • Having had polyps, inflammatory bowel disease (IBD) or colorectal cancer
  • Having a family history of the disease

Screening methods

The colonoscopy remains the gold standard for colorectal screening. But this doesn't have to be the first test you have; there are several other easier and less invasive options.

Talk to your doctor about each test so the two of you can determine the screen that's best suited for you. 

"The success of any screening program, especially colorectal cancer screening, is dependent on the appropriate testing and follow-up of patients with abnormal screening results as well as following up with patients for repeat testing at designated intervals," Dr. Hood said.

Intervals for screening

Here are the amounts of time between each test:

  • Colonoscopy - 10 years
  • Flexible sigmoidoscopy, virtual colonoscopy (CT scan), double contrast barium enema - 5 years
  • Fecal occult test (looking for blood in fecal sample) - every year
  • Screenings are not recommended for people older than age 75 or individuals who have a life expectancy of less than 10 years.

The ACP supported the development of this guidance statement. 

Several authors disclosed financial relationships with the following: Qualchoice, MedStudy, VEMCO MedEd Corp, and ECRI.

Reviewed by: 
Review Date: 
March 5, 2012
Last Updated:
March 5, 2012