The following recommendations are for persons who have never had a colorectal cancer or pre-cancerous polyps (adenomatous type polyps). These are derived from the American College of Gastroenterology. You may visit the ACG website at www.acg.gi.org for more information.
Persons at Average Risk
Average risk persons are defined as age 50, a normal physical exam, absence of symptoms, absence of family history of colorectal cancer or colorectal polyps, and no evidence of microscopic blood within the stool (fecal occult blood test cards) on 3 sequential tests.
Recommendation
Alternative Strategy
NB: If annual fecal occult blood test cards are positive for blood, a colonoscopy should be performed regardless of the number of cards that are positive.
Moderately Increased Risk
Moderately increased risk persons are defined as those persons with one first-degree relative (mother, father, or sibling) with colorectal cancer diagnosed at age 60 or older.
Recommendation
Alternative Strategy
High Risk Individuals
High-risk persons are defined as those persons with two or more first-degree relatives (mother, father or sibling) with colorectal cancer diagnosed at age less than 60.
Recommendation
Colonsocopy should be repeated every 3 to 5 years.
Alternative Strategy
Colonic Polyps
Persons with family members with colonic polyps are at increased risk for development of colorectal cancer. Those patients should have individualized screening performed. However, the screening recommendations from the American College of Gastroenterology are similar to those described above for colorectal cancer.
Medicare allows for colonoscopy as often as every 2 years, which may be needed depending on other factors. Your gastroenterologist (gastrointestinal specialist) will decide what interval is appropriate in your individual case.
Genetic testing (blood sample testing) is available only for Familial Adenomatous Polyposis (FAP) and Herditary Nonpolyposis Colorectal Cancer (HNPCC) patients. These are inherited syndromes with their own screening recommendations.
Surveillance of Colorectal Cancer
Persons who have had colorectal Cancer or Pre-cancerous Colorectal Polyps require continued evaluation of the colon to prevent recurrence of colon polyps and colorectal cancer. This process is called surveillance.
Recommendations for Surveillance of Colorectal Cancer and Polyps
| Findings of Most Recent Colonoscopy | ACG Recommendations |
| Colorectal Cancer | Colonoscopy between 3 months and 1 yr. * |
| Pre-Cancerous Polyps | Colonoscopy between 3 months and 1 yr. * |
| Normal Examination | Colonoscopy -- usually in 5 years |
* Most patients can have their next colonoscopy in 3-5 years, but some patients will need colonoscopy repeated in as little as 3 months to 1 year. Medicare allows colonoscopy as frequently as 2 years to allow for special circumstances and covers more frequent intervals when medically indicated. Your gastrointestinal specialist will decide what interval is most appropriate in your individual case.
NB: Patients with ulcerative colitis involving most of the colon for more than 8 years, or involving the left colon for 15 years or more are at increased risk for colorectal cancer. In addition, patients with long standing Crohn's Disease are at increased risk for colorectal cancer. These patients should undergo colonoscopy every 1 to 2 years. Your gastrointestinal specialist will assist you further in determining your individual needs.
 |
 |
 |
|
|||