The National Comprehensive Cancer Network (NCCN), an alliance of 21 of the world’s leading oncology centers, establishes guidelines for the screening and treatment of cancer; it updates the screening procedures annually or as needed to capture the latest data. The following are the NCCN’s current screening guidelines for colon cancer.

Individuals who are 50 or older have different screening options for colorectal cancer, although a colonoscopy is the preferred method. There are five screening schedules based on the type of screening test as well as initial findings that indicate that no cancer or other serious conditions exist. If abnormal results are produced by any of these screening methods, a colonoscopy should follow.

• Colonoscopy every 10 years. A colonoscopy includes the evaluation of the entire large intestine through a lighted camera that is inserted through the rectum. The image of the large intestine is shown on a screen so the physician can identify any abnormal-looking areas. A biopsy )sample of tissue) may be obtained during the colonoscopy to determine if cancer or other diseases exist.
• Flexible sigmoidoscopy every five years. A sigmoidoscopy includes the evaluation of the lower portion of the large intestine. A lighted camera is inserted through the rectum so the physician can visually examine the area for abnormalities.
• Fecal occult blood test (FOBT) or fecal immunochemical test (FIT) every year. FOBT and FIT tests can detect small amounts of blood or cellular changes in the stool that may be indicative of colorectal cancer. FOBT may be performed at home with a kit that is provided to patients.
• FOBT or FIT test every year plus flexible sigmoidoscopy every five years. This combination method is preferred to either yearly FOBT/FIT or flexible sigmoidoscopy every five years.
• Double-contrast barium enema every five years. An enema including barium contrast is given prior to an X-ray. The barium contrast allows the physician to visualize the colon on X-ray and detect any abnormalities.

Individuals with the following high-risk factors should discuss their own health history and family health history with their physician to determine their optimal individual screening schedule.

• A strong family history of colorectal cancer or colorectal polyps (growths that are not cancerous but are often considered a precursor to cancer) including first-degree relatives (parent, sibling, or child) younger than 60 or two first-degree relatives of any age
• A history of colorectal cancer or colorectal polyps
• A history of chronic inflammatory bowel disease
• A family history of hereditary colorectal cancer syndrome (familial adenomatous polyposis or hereditary nonpolyposis colon cancer)

Get Screened

It is important that everyone undergo screening for cancer, including colon cancer, to ensure optimal chances of early detection or prevention and, ultimately, long-term survival. If family health history is accessible, understanding this link is important so that discussions with healthcare providers can be held and appropriate assessments in terms of the hereditary risk of developing certain cancer can be made. Screening schedules will be revised to reflect each individual’s risks.