What are the screening guidelines for colorectal (cancer of the colon or rectum) cancer in adults aged 50 to 75 years?

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From the Guidelines

Colorectal cancer screening is strongly recommended for all adults aged 50 to 75 years, with the preferred screening options including colonoscopy every 10 years, flexible sigmoidoscopy every 5-10 years, multitarget stool DNA test every 3 years, CT colonography every 5 years, or annual fecal immunochemical test (FIT) 1. The American College of Gastroenterology, American Cancer Society, and US Preventive Services Task Force all support screening adults between ages 50 and 75 years with any test, with a strong recommendation for colonoscopy every 10 years or FIT every 1 year as primary screening modalities 1. Key considerations for screening include:

  • Average-risk adults should begin screening at age 50, though some guidelines recommend starting at age 45 due to increasing rates of colorectal cancer in younger adults 1
  • Screening should continue through age 75, after which the decision to continue screening should be individualized based on prior screening history, life expectancy, and patient preferences 1
  • Patients with a family history of colorectal cancer or advanced adenoma should begin screening at age 40 or 10 years before the earliest diagnosis of colorectal cancer, with colonoscopy every 5 years as the recommended screening modality 1 The chosen screening method should be based on patient preferences, medical history, and risk factors, with the goal of detecting precancerous polyps or early-stage cancer when treatment is most successful 1.

From the Research

Screening Guidelines for Colorectal Cancer

The screening guidelines for colorectal cancer in adults aged 50 to 75 years are as follows:

  • Adults aged 50-75 years should be screened for colorectal cancer 2, 3, 4, 5, 6
  • Recommended screening options include:
    • Colonoscopy every 10 years 2, 3, 4, 5, 6
    • Sigmoidoscopy every 5 years 4
    • CT colonography every 5 years 3, 5
    • Guaiac fecal occult blood testing (FOBT) annually or biennially 2, 3, 4
    • Fecal immunochemical testing (FIT) annually or biennially 2, 3, 4, 5
    • FIT-DNA (FIT in combination with a stool DNA test) every 3 years 2
    • Multi-target stool DNA (mt-sDNA) test 3
  • The US Preventive Services Task Force recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years 6

Factors to Consider

When choosing a screening test, factors to consider include:

  • Invasiveness of the test 3
  • Test performance 3
  • Screening interval 3, 4, 5
  • Accessibility 3
  • Cost 3
  • Patient preferences and local resource availability 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Screening for Colorectal Cancer in the United States: Correlates and Time Trends by Type of Test.

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2021

Research

Optimal Strategies for Colorectal Cancer Screening.

Current treatment options in oncology, 2022

Research

Colorectal cancer screening guidelines for average-risk and high-risk individuals: A systematic review.

Romanian journal of internal medicine = Revue roumaine de medecine interne, 2024

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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