Colon Cancer Screening Guidelines

Medically Reviewed by Nayana Ambardekar, MD on November 20, 2022
2 min read

Getting regular checkups and colon cancer screening is the best way to prevent colorectal cancer. The US Preventive Services Task Force and the American Cancer Society both recommend that people begin screening tests at age 45. Finding and removing colon polyps may help prevent colon cancer. In addition, colon cancer screening may help find cancer early, making a cure more likely. Your gastroenterologist will determine and explain the interval between colonoscopies because it is dependent on a variety of factors (including how good the prep is).

People with the following risks should begin colon screening before age 45.

  • Personal history of colon polyps
  • History of inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
  • Close relatives who have had colorectal disease or polyps before age 60 or two first degree relatives with colon cancer at any age
  • Family history of familial adenomatous polyposis or hereditary non-polyposis colon cancer

Specific recommendations for high-risk people are as follows:

  • Colonoscopy at the time of initial polyp diagnosis
  • If 1-2 small adenomatous polyps with low grade abnormality, repeat in 5 years.
  • If 3-10 adenomatous polyps or 1 adenomatous 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
  • Colonoscopy within one year after surgery; if normal, repeat in three years; if still normal, repeat in five years.
  • 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.
  • At age 10 to 12, begin screening with colonoscopy and continue yearly.
  • If positive genetic test, colon removal should be considered because of very high risk of colorectal cancer.
  • Colonoscopy every one to two years, starting at age 20 to 25 or2 to 5 years before the age that an immediate family member had cancer, whichever is earlier
  • Genetic testing offered to first-degree family members
  • Colonoscopy every one to two years, starting eight years after the start of disease