In 2008, both the USPSTF and a collaborative multiorganizational group, consisting of the ACS Colorectal Cancer Advisory Group, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology Colon Cancer Committee, issued updated guidelines for colorectal cancer screening. An abbreviated summary is provided below.
■ Offer patients at average risk for colorectal cancer a range of screening options beginning at age 50 years: annual screening with high-sensitivity fecal occult blood tests (including guaiac-based hemoccult tests and fecal immunochemical tests), colonoscopy every 10 years, or sigmoidoscopy every 5 years (which can be combined with high-sensitivity fecal occult blood testing performed every 3 years). The multiorganizational group also endorsed the options of double-contrast barium enema or computed tomography colonography every 5 years and periodic fecal DNA testing.39 Guidelines recommend against screening with fecal occult blood testing following a DRE. Routine screening should continue until age 75 years.
■ Identify higher-risk persons based on a personal history of colorectal neoplasia or long-standing IBD—or a family history of colorectal neoplasia, including hereditary syndromes. These individuals will require intensive screening and surveillance testing with colonoscopy; screening will begin at a younger age and be repeated at shorter intervals than for those at average risk.
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