Colon Cancer Screening Guidelines

Watch how a polyp is removed during a colonoscopy to prevent colon and rectal cancer.

Our experts can usually cure colon cancer if they find it early enough. But the more that colon cancer grows, the more difficult it can be to treat.

  • For people with an average risk who have no symptoms, MSK’s doctors recommend screening tests for colon cancer every ten years, starting at age 50.
  • People at a higher risk may benefit from earlier, more frequent screenings.
  • At MSK, a colonoscopy is the preferred screening method. This procedure both finds and removes small clumps of cells on the inner lining of the colon. These are called polyps, and they can grow into cancer.

You may be worried about symptoms and wonder if you should talk to your doctor about screening. It’s a conversation worth having. Many experts believe that deaths from colon cancer have gone down over the past few decades because more people are getting screened.

Today, more than 60 percent of people age 50 to 75 are regularly screened for the disease. Doctors are detecting colon cancer more often and at an earlier stage, when it’s most treatable. In fact, 90 percent of people with colon cancer live five years or more after treatment if the cancer is found and removed at any early stage.

MSK’s screening guidelines for colorectal cancer are based on your risk and factors specific to you. These include your age, personal and medical history, and genetics.

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What is the average risk of colon cancer?

If you are age 50 or older, you are at an average risk of colon cancer if you have the following:

  • no symptoms
  • no personal or family history of colorectal cancer or precancerous polyps (noncancerous growths in the inside surface of the colon or rectum)
  • no personal history of inflammatory bowel disease, such as ulcerative colitis or Crohn’s colitis
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What is an increased risk of colon cancer?

If you have an increased risk of colorectal cancer, discuss with your doctor if you should have earlier, more frequent screenings.

You are at an increased risk if you have one of the following:

  • a personal history of colorectal cancer or precancerous polyps
  • a family history of a first-degree relative (such as a parent or sibling) who had cancer or precancerous polyps in the colon or rectum before age 50, or multiple family members with colorectal cancer or polyps
  • a personal history of long-standing (more than eight years) inflammatory bowel disease, such as ulcerative colitis or Crohn’s colitis
  • a family history of familial adenomatous polyposis (FAP). This condition is a rare form of hereditary colon cancer. FAP can lead to the development of hundreds or thousands of polyps in the colon at a very early age. If left untreated, people with FAP will almost always develop colon cancer by age 40.
  • a family history of Lynch syndrome (formerly known as hereditary nonpolyposis colorectal cancer). This condition is caused by mutations in specific genes. It accounts for approximately 2 to 3 percent of all colorectal cancer diagnoses.
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What should I know about family history and the genetic causes of colon cancer?

If you have more than one family member with colon or rectal cancer, or if you have a family member who had early-onset colorectal cancer (before age 50), your care team can help determine if you may be at risk of a possible hereditary condition that makes you more likely to develop cancer. If your care team feels that you may be at risk, we can refer you to our Clinical Genetics Service for further evaluation and customized screening options.

Learn more about the genetic causes of colon cancer.

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What if I have been treated for cancer before?

You may have an increased risk of colorectal cancer if you’ve had therapy for another type of cancer. In that case, your care team may recommend more frequent screenings.

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What should I know about colon cancer if I am under age 50?

Real progress is being made against colon cancer, as more people are screened and treatment options improve. But in recent years there is a disturbing rise in colon cancer diagnoses in people under 50. That’s younger than the usual age to begin screening. MSK doctors and scientists are working to find out what’s behind this troubling trend. MSK has established the first center focused on people with colon cancer under 50.

Learn more about colon cancer under 50.

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What should I know about screening tests for colon cancer?

At MSK, a colonoscopy is the preferred screening method. This procedure both finds and removes small clumps of cells on the inner lining of the colon called polyps. Not all polyps are harmful. But some can grow into colon cancer. A colonoscopy is the only screening method that not only detects cancer at its earliest stages but can also prevent it.

Learn more about a colonoscopy and other screening tests for colon cancer.

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