Who Is at Risk for Colorectal Cancer and When Should Screening Begin?

Colon cancer can affect anyone, although those with a family history have a higher risk for developing the disease. Screenings are recommended beginning at age 50. Dr. Djenaba A. Joseph explains what conditions necessitate screenings.

Dr. Djenaba A. Joseph:  So when you think about people who are at risk for colorectal cancer, short answer is everybody.  The long answer is that your risk actually increases after the age of 50.  So if you were look at a graph, it will be flat, flat, flat, flat, flat and then when you hit 50, the number of people who have colorectal cancer will start to go up pretty dramatically.  So that’s why we recommend people start getting screened for colorectal cancer starting at age 50.  Then there are people who have a family history of colorectal cancer, so if you have a mother or father or a sister or a brother who is diagnosed with colorectal cancer at a young age say like 45, you would actually need to start getting screened much earlier, because you are at higher risk for that disease and then there are certain genetic syndromes that caused people to get colorectal cancer very early in life.  So, the frequency at which you get screened depends on what test you used, so let’s say you turn 50 and you decide you are going to have colonoscopy to get screened for colorectal cancer.  So if you have your colonoscopy and it is completely normal and they don’t find anything, then you don’t need to have another one for 10 years.  Another option is to have what we call a fecal occult blood test, those you need to do every year.  So you do one when you turn 50, if it’s negative, you do another one when you are 51, if that’s negative, and so on and so forth, and then the other option is what we call a flexible sigmoidoscopy and you can do those every five years, but you also need to that with a fecal occult blood test every three years, so it’s a little more complicated, but that is another option.  So there are actually a variety of tests that can be used to screen for colorectal cancer, the United States Preventive Services Task Force recommends either a colonoscopy every 10 years or a fecal occult blood test every year or a flexible sigmoidoscopy every five years with a fecal occult blood test every three years.  So, there are other organizations that recommend other tests so the American Cancer Society in addition to those that I just mentioned they also recommend a double barium enema.  There is also something called a virtual colonoscopy, which is basically a CT scan of your colon to see if they see any polyps in there.  So when you go to your doctor, they may give you a bunch of different options for getting screened, so you just need to be aware about the pros and cons of each test.

Djenaba A. Joseph, MD, MPH, is board certified in internal medicine and is a Commander in the Commissioned Corps of the U.S. Public Health Service. She is currently the Medical Director of CDC’s Colorectal Cancer Control Program (CRCCP).

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This information should not be relied upon as a substitute for personal medical advice, diagnosis or treatment. Use the information provided on this site solely at your own risk.  If you have any concerns about your health, please consult with a physician.


This information should not be relied upon as a substitute for personal medical advice, diagnosis or treatment. Use the information provided on this site solely at your own risk. If you have any concerns about your health, please consult with a physician.

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