Sunday, January 15, 2012

COLON CANCER SCREENING PLANS

The recommended colon cancer screening plan depends upon your risk of colorectal cancer.

Average risk of colorectal cancer — People with an average risk of colorectal cancer should begin screening at age 50. One of the following screening strategies is recommended :

Colonoscopy every 10 years

Computed tomographic colonography every 5 years

Flexible sigmoidoscopy every five years

Double contrast barium enema every five years

Stool testing is an alternate option and is recommended once per year (for guaiac and immunologic tests, less frequently for DNA-based tests).

Increased risk of colorectal cancer — Screening plans for people with an increased risk may entail screening at a younger age, more frequent screening, and/or the use of more sensitive screening tests (usually colonoscopy). The optimal screening plan depends upon the reason for increased risk.

Family history of colorectal cancer

People who have one first-degree relative (parent, brother, sister, or child) with colorectal cancer or adenomatous polyps at a young age (before the age of 60 years), or two first-degree relatives diagnosed at any age, should begin screening for colon cancer earlier, typically at age 40, or 10 years younger than the earliest diagnosis in their family, whichever comes first. Screening usually includes colonoscopy, which should be repeated every five years.


People who have one first-degree relative (parent, brother, sister, or child) who has experienced colorectal cancer or adenomatous polyps at age 60 or later, or two or more second degree relatives (grandparent, aunt, uncle) with colorectal cancer should begin screening by colonoscopy at age 50, and screening should be repeated as for average risk people.

People with a second-degree relative (grandparent, aunt, or uncle) or third-degree relative (great-grandparent or cousin) with colorectal cancer are considered to have an average risk of colorectal cancer.

Some people have known genetically-based colon cancer syndromes in their family, such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colon cancer (HNPCC). These less common conditions require aggressive screening and preventive treatments, and individuals with these conditions in their family should be managed by a clinician with clinical expertise in these syndromes.

Inflammatory bowel disease — People with ulcerative colitis or Crohn's disease have an increased risk of colon cancer. The best screening plan depends upon how much of the colon is affected and how long you have had the disease.

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