What are the latest guidelines for colonoscopy in women?

From the Guidelines

The latest guidelines recommend that women at average risk for colorectal cancer should begin regular colonoscopy screening at age 45 and continue until age 75, with screening occurring every 10 years for those with normal results, as supported by the most recent evidence from 1. The American Cancer Society and other organizations have updated their guidelines to reflect the changing landscape of colorectal cancer incidence and mortality, with a focus on early detection and prevention.

• The guidelines emphasize the importance of individualized screening decisions, taking into account patient preferences, life expectancy, health status, and prior screening history.
• For women with a family history of colorectal cancer, personal history of inflammatory bowel disease, or genetic syndromes like Lynch syndrome, screening should start earlier, often at age 40 or 10 years before the youngest case in the family, as recommended by 1.
• The colonoscopy preparation typically involves a clear liquid diet the day before the procedure and consuming a bowel-cleansing solution such as GoLYTELY, MoviPrep, or SUPREP as directed, with split-dosing now preferred to improve bowel cleanliness.
• Women should arrange for someone to drive them home after the procedure due to sedation effects, and the procedure itself takes about 30-60 minutes, during which the doctor examines the entire colon for polyps or abnormalities.
• Colonoscopy is considered the gold standard for colorectal cancer screening because it allows for both detection and removal of precancerous polyps in a single session, effectively preventing cancer development, as noted in 1 and 1. Key considerations for clinicians include:
• Providing guidance to adults about the benefits, limitations, and potential burdens associated with screening test options, as emphasized in 1.
• Assisting patients in making a choice and completing screening, with a focus on improving screening utilization and adherence.
• Staying up-to-date with the latest guidelines and recommendations, such as those from the American Cancer Society and the US Multi-Society Task Force on Colorectal Cancer, as referenced in 1.

From the Research

Latest Guidelines for Colonoscopy in Women

The latest guidelines for colonoscopy in women are as follows:

• The American College of Obstetricians and Gynecologists recommends colonoscopy for colorectal cancer screening every 10 years for average-risk women beginning at age 50 years and at age 45 years for African American women 2.
• For high-risk individuals with a positive family history of colorectal cancer or advanced colorectal polyp, screening should begin at age 40 3, 4.
• Colonoscopy is recommended every 10 years for average-risk individuals and every 5-10 years for high-risk individuals 3.
• The U.S. Multi-Society Task Force on Colorectal Cancer recommends colonoscopy every 10 years and annual fecal immunochemical test (FIT) as the cornerstones of screening 4.

Screening Intervals and Modalities

The recommended screening intervals and modalities are:

• Colonoscopy every 10 years for average-risk individuals and every 5-10 years for high-risk individuals 3, 4.
• FIT annually in average-risk individuals and every 1-2 years in high-risk individuals 3.
• CT colonography every 5 years 4.
• Flexible sigmoidoscopy every 5 to 10 years 4.

Special Considerations

Special considerations for women include:

• African American women should begin screening at age 45 years 4, 2.
• Women with a family history of colorectal cancer or advanced adenoma should undergo screening by colonoscopy every 5 years, beginning 10 years before the age at diagnosis of the youngest affected relative or age 40, whichever is earlier 4.
• Women with a personal history of chronic ulcerative colitis and Crohn colitis should undergo colonoscopy every 1 to 2 years, with biopsies for dysplasia 5.