Colorectal Cancer Screening Guidelines & Tests

Cancer screenings are medical tests that are performed when a person has no symptoms. USPSTF guidelines recommend men and women, beginning at age 50, should follow one of the five examination schedules below. All positive tests (FOBT, FIT, flexible sigmoidoscopy, barium enema) should be followed up with a colonoscopy. Early detection is one of the many benefits to following the below guidelines.

The screening guidelines below apply to most adults.

Age 50 or older

Follow ONE of the screening options below:

  • Colonoscopy every 10 years.
  • Virtual colonoscopy (also called Computed Tomographic Colonography) every five years. A colonoscopy will be performed if polyps are found.
  • Fecal Occult Blood Test (FOBT) Another option is a stool-based test every year.

Your doctor can help you decide if you should continue screening after age 75. MD Anderson doesn’t recommend screening for adults after age 85.

If you choose a virtual colonoscopy, check with your insurance provider before scheduling an exam. Not all insurance providers cover the cost of this exam.

Exams for adults at increased or high risk

People at moderate or high risk for colon cancer (e.g., strong family history) should talk with their doctor about the need for a different testing schedule.

You’re at increased or high risk if you fall under one or more of these groups:

  • Personal history of precancerous colon polyps (adenomas)
  • Family history of colorectal cancer or precancerous polyps (adenomas). In other words, a family member had or has colorectal cancer or precancerous polyps.
  • Personal history of Familial Adenomatous Polyposis or suspected Familial Adenomatous Polyposis without yet having undergone genetic testing
  • Personal history of Hereditary Nonpolyposis Colorectal Cancer or family history of Hereditary Nonpolyposis Colorectal Cancer
  • Inflammatory bowel disease (chronic ulcerative colitis or Crohn’s disease)

These screening guidelines are provided as a guide. If results of these exams suggest cancer, more extensive diagnostic tests of the colon or rectum should be conducted. More frequent exams are needed if polyps (precancerous lesions) are found. Earlier screening is recommended for individuals with an increased risk due to a family history of colon cancer or polyps, or a personal history of inflammatory bowel disease.