Colorectal cancer screening
Summary of the 2021 recommendation from the U.S. Preventive Services Task Force.
Who it applies to
Adults at average risk of colorectal cancer, with no symptoms, no prior colorectal cancer or advanced polyps, and no inherited syndromes such as Lynch syndrome or familial adenomatous polyposis.
Recommendation
Screen all adults aged 50 to 75 (grade A). Screening is also recommended for adults aged 45 to 49 (grade B), which lowered the starting age from 50 in the 2021 update. For adults aged 76 to 85, the decision to screen should be individual, based on overall health, prior screening history and personal preference (grade C).
Screening options and intervals
- Stool-based tests: fecal immunochemical test (FIT) every year, high-sensitivity guaiac test every year, or multitarget stool DNA test every 1 to 3 years.
- Direct visualization: colonoscopy every 10 years, CT colonography every 5 years, or flexible sigmoidoscopy every 5 years (or every 10 years combined with yearly FIT).
A positive result on any non-colonoscopy test should be followed up with a colonoscopy.
Notes
People with a family history of colorectal cancer or other risk factors may need to start earlier or screen more often and should discuss this with a clinician.