Screening Guidelines

Our screening guidelines are based on your risk for developing colon and rectal cancer. Our experts recommend routine screening every ten years for people age 50 and older who have an average level of risk and no symptoms. At Memorial Sloan Kettering, we also recommend colonoscopy as the preferred colon and rectal cancer screening tool.

If you are age 50 and older, you are at average risk if you have the following:

  • no symptoms
  • no personal or family history of colorectal cancer or precancerous polyps (benign growths in the inside surface of the colon or rectum)
  • no personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s colitis)
  • no family history of colorectal cancer precancerous polyps

People with an increased risk for colorectal cancer may benefit from earlier, more frequent screenings.

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

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

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

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