Screening Guidelines

Our screening guidelines are based on your risk for developing colorectal cancer. Our experts recommend routine colorectal cancer screening every ten years for people age 50 and older who have an average level of risk and no symptoms. We also recommend colonoscopy as the preferred colorectal cancer screening tool.

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

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

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

You are defined as high risk if you have one of the following:

  • a first-degree relative (parent or sibling) who had cancer or a premalignant lesion (known as an adenomatous polyp) in the colon before the age of 50
  • a family history of familial adenomatous polyposis (FAP). A rare form of hereditary colon cancer, FAP is a condition that leads to the development of hundreds or thousands of polyps in the colon at a very early age. These individuals will almost always go on to develop colon cancer by age 40.
  • a family history of hereditary nonpolyposis colorectal cancer, a syndrome caused by mutations in specific genes that accounts for approximately 5 percent of all colorectal cancer diagnoses
  • a long history (more than eight years) of inflammatory bowel disease (ulcerative colitis or Crohn’s colitis)

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 colorectal 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 an underlying hereditary cancer predisposition syndrome. 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.