Recommendations for Colorectal Cancer Screening in High-Risk Individuals

Table 4: Recommendations for Colorectal Cancer Screening in High-Risk Individuals.

Risk Factor	Recommendation
One first-degree relative with advanced adenoma or CRC at < 60 years of age or two first-degree relative with advanced adenoma or CRC at any age	Colonoscopy every 5 years starting at age 40 years or 10 years younger than youngest affected relative's age at diagnosis, whichever is earlier
Familial Adenomatous Polyposis (FAP) or family history of FAP	Colonoscopy or flexible sigmoidoscopy annually as appropriate starting at puberty until patient and physician determine appropriate time for colectomy
Hereditary Non-Polyposis Colorectal Cancer(HNPCC or Lynch Syndrome) or family history of HNPCC	Colonoscopy every 2 years starting at age 20-25 years until age 40; then annually after age 40
Crohn's Disease & Ulcerative Colitis	Generally recommend screening colonoscopy 8-10 years after initial diagnosis

Advanced adenoma: adenoma 10 mm or greater, has villous elements, or high grade dysplasia

CRC: colorectal cancer