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Colon Cancer Screening Guidelines

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Getting regular checkups and colon cancer screening is the best way to prevent colorectal cancer. Finding and removing colon polyps helps prevent colon cancer. In addition, colon cancer screening helps find cancer early, making a cure more likely.

Colon Cancer Screening for People at High Risk

People with the following risks should begin colon screening before age 50.

Specific recommendations for high-risk people are as follows:

People with history of multiple or large polyps

  • Colonoscopy at the time of initial polyp diagnosis
  • If 1-2 small adenonatous polyps with low grade abnormality, repeat in 5 years.
  • If 3-10 adenomatous polyps or 1 adenomoatous polyp greater than 1 centimeter, repeat colonoscopy within three years after polyp removal 
  • With certain types of polyps or with high grade abnormality, repeat colonoscopy within three years
  • If normal, repeat again in five years
  • If more than 10 adenomatous polyps, repeat in less than 3 years
  • If polyps are permanently attached and not on a stem and are removed in portions, repeat colonoscopy in 2-6 months to verify complete polyp removal


People who have had surgery for colorectal cancer

  • Colonoscopy within one year after surgery; if normal, repeat in three years; if still normal, repeat in five years.

People with a family history

  • Colonoscopy at age 40 or 10 years before the age that the immediate family member was diagnosed with cancer, whichever is earlier; if normal, repeat every five years.


People with a family history of familial adenomatous polyposis

  • At age 10 to 12, annual flexible sigmoidoscopy. 
  • If positive genetic test, colon removal should be considered because of very high risk of colorectal cancer.

People with a family history of hereditary nonpolyposis colon cancer

  • Colonoscopy every one to two years, starting at age 20 to 25 or 10 years before age that immediate family member had cancer, whichever is earlier
  • Genetic testing offered to first-degree family members

People with inflammatory bowel disease

  • Colonoscopy every one to two years, starting eight years after the start of pancolitis (involvement or the entire colon) or 12-15 years after the start of left-sided colitis 

WebMD Medical Reference

Reviewed by David T. Derrer, MD on May 21, 2014
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