At what age should I be screened for neuroendocrine tumors (NETs) of the sigmoid colon given my mother's diagnosis at 58?

Colorectal Cancer Screening for Individuals with a Family History of Neuroendocrine Tumor

You should begin colorectal cancer screening at age 40, which is 10 years earlier than the general population recommendation, due to your mother's diagnosis of a neuroendocrine tumor of the sigmoid colon at age 58. 1

Rationale for Early Screening

The guidelines from major medical organizations provide clear recommendations for individuals with a family history of colorectal neoplasia:

• According to the Gastroenterology guidelines, people with a first-degree relative (parent, sibling, or child) with colon cancer or adenomatous polyps diagnosed at age ≥60 years should be screened as average-risk persons but beginning at age 40 years 1

• This recommendation applies to your situation since:

  • Your mother is a first-degree relative
  • She was diagnosed with a sigmoid colon neoplasm (neuroendocrine tumor) at age 58
  • Although her tumor was neuroendocrine rather than adenocarcinoma, the location and family relationship still warrant earlier screening

Screening Method Recommendations

For your specific risk profile, the following screening options are appropriate:

• First-tier options (strongly recommended):

  • Colonoscopy every 10 years
  • Annual FIT (Fecal Immunochemical Test) 1

• Alternative options if you decline the first-tier tests:

  • Flexible sigmoidoscopy every 5-10 years
  • CT colonography every 5 years
  • FIT-fecal DNA every 3 years 1

Important Considerations

Neuroendocrine Tumors vs. Adenocarcinoma

While most colorectal cancer screening guidelines focus on adenocarcinoma (the most common type), neuroendocrine tumors (NETs) of the colon are relatively rare but can have poor prognosis if not detected early 2, 3. NETs are often diagnosed at a median age of 63 years 3, but family history may indicate earlier risk.

Screening Intervals

After your initial screening at age 40, follow the standard intervals based on findings:

• If normal: repeat colonoscopy every 10 years
• If polyps or other abnormalities are found: follow your physician's recommendations for more frequent surveillance

Common Pitfalls to Avoid

1. Delaying screening: Don't wait until age 50 (the standard recommendation for average-risk individuals)
2. Choosing inappropriate screening tests: For your risk profile, colonoscopy is preferred as it allows for direct visualization and removal of precancerous lesions
3. Ignoring symptoms: Regardless of screening schedule, promptly report any concerning symptoms such as rectal bleeding, change in bowel habits, or abdominal pain

Special Considerations

If additional risk factors are present (such as multiple affected relatives or relatives diagnosed at younger ages), even earlier screening may be warranted 1. However, based on the information provided about your mother's single diagnosis at age 58, beginning at age 40 is appropriate.

The recommendation to begin screening at age 40 aligns with the American Gastroenterological Association's guidance that screening should start at age 40 for persons with first-degree relatives with colon cancer 1.