Colorectal Cancer

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Screening for colorectal cancer:

Screening can detect colorectal cancer at an earlier stage so that cancer can be cured.

American Cancer Society Guideline for Colorectal Cancer Screening

People at average risk* of colorectal cancer start regular screening at age 45.

People who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through the age of 75.

For people ages 76 through 85, the decision to be screened should be based on a person’s preferences, life expectancy, overall health, and prior screening history.

People over 85 should no longer get colorectal cancer screening.

*For screening, people are considered to be at average risk if they do not have:

  1. A personal history of colorectal cancer or certain types of polyps
  2. A family history of colorectal cancer
  3. A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
  4. A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
  5. A personal history of getting radiation to the abdomen (belly) or pelvic area to treat a prior cancer

People at increased or high risk of colorectal cancer might need to start colorectal cancer screening before age 45, be screened more often, and/or get specific tests. This includes people with:

  1. A strong family history of colorectal cancer or certain types of polyps (see Colorectal Cancer Risk Factors)
  2. A personal history of colorectal cancer or certain types of polyps
  3. A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
  4. A known family history of a hereditary colorectal cancer syndromes such as familial adenomatous polyposis (FAP) or Lynch syndrome (also known as hereditary non-polyposis colon cancer or HNPCC)
A personal history of radiation to the abdomen (belly) or pelvic area to treat a prior cancer

Test options for colorectal cancer screening

Several test options are available for colorectal cancer screening:

Stool-based tests

  1. Highly sensitive fecal immunochemical test (FIT) every year
  2. Highly sensitive guaiac-based fecal occult blood test (gFOBT) every year
  3. Multi-targeted stool DNA test (MT-sDNA) every 3 years

Visual (structural) exams of the colon and rectum

Colonoscopy every 10 years

  1. CT colonography (virtual colonoscopy) every 5 years
  2. Flexible sigmoidoscopy (FSIG) every 5 years

Treatment:

Colon Cancer:

  1. Stage 1 Colon cancer: surgery only
  2. Stage 2 Colon cancer: surgery only and sometimes chemotherapy is also given after surgery
  3. Stage 3 Colon cancer: surgery followed by Chemotherapy
  4. Stage 4 Colon cancer: Chemotherapy + Targeted therapy, Immunotherapy. sometimes surgery is also done

Rectal Cancer:

  1. Stage 1 Rectal Cancer: surgery only
  2. Stage 2 Rectal Cancer: surgery only and sometimes chemotherapy is also given after surgery
  3. Stage 3 Rectal Cancer: Radiotherapy + surgery + Chemotherapy
  4. Stage 4 Rectal Cancer: Chemotherapy +Targeted therapy, Immunotherapy. sometimes surgery is also done