Colon Cancer Screening Guidelines

Getting regular checkups and colon cancer screening is one of the best ways to prevent colorectal cancer. Finding and removing colon polyps early helps prevent 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, according to the American Cancer Society.

• Personal history of colorectal cancer or colon polyps called adenomatous polyps
• History of inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
• Strong family history of colorectal disease or polyps
• Family history of familial adenomatous polyposis or hereditary non-polyposis colon cancer

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
• Colonoscopy within three years after polyp removal; if normal, repeat again in five years 

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 age that immediate family member had cancer, whichever is earlier; if normal, repeat every five years

People with a family history of familial adenomatous polyposis

• At age 10 to 12, 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; repeat every one to two years