COLONOSCOPY SCREENING FOR COLON CANCER

Question 1

Routine screening

Answer 1

Every 10 years beginning at age of 45 years for men and women

Question 2

Single family member past history

Answer 2

10 years earlier than the age at which the family member developed their cancer or age 40, whichever is younger. Repeat every 5 years. Increase frequency of multiple family members are affected, especially before 50 years

Question 3

Previous Adenomatous polyp

Answer 3

Colonoscopy every 3 to 5 years

Question 4

Previous personal history of colon cancer

Answer 4

Colonoscopy at 1 year after resection, then at 3 years, then every 5 years

Question 5

Lynch syndrome (HNPCC)

Answer 5

Colonoscopy at age 25, repeat every 1 to 2 years

Question 6

FAP

Answer 6

Colonoscopy at age 12, repeat every year

Question 7

Peutz-Jeghers syndrome

Answer 7

Colonoscopy every 3 years starting at age 8

Question 8

IBD

Answer 8

(Extensive colitis in CD/UC) colonoscopy 8-10 years after diagnosis
- High risk patients (colitis with moderate/severe activity, PSC, or FH of CRC in first degree relative <50 years)are offered a further colonoscopy and multiple biopsy (to look for dysplasia) 1 year later
- Lower risk patients undergo colonoscopy 3-5 years later
- Colectomy is recommended if high grade dysplasia is discovered and increased surveillance (6-12 monthly) with low-grade dysplasia

Question 9

Note

Answer 9

Colonoscopy is the gold standard for screening, but other options are available for average risk individuals if colonoscopy is not available
- Annual FOBT
- Flexible sigmoidoscopy every 5 years
- FOBT and flexible sigmoidoscopy every 5 years
- DCBE every 5 to 10 years