Colorectal Cancer Screening Guidelines

Occult Blood Testing

Colorectal Cancer Screening Guidelines


The American Cancer Society has associated certain risk factors with colorectal cancer, ranging from lifestyle choices to non-lifestyle related factors.

Aside from high-sensitivity FOBT testing, there are other procedures that the Center for Disease Control has identified that can detect colorectal cancer in patients, before it’s too late.

Summary of Risk Factors for Colorectal Cancer

Life-Style Related Risk Factors

  • A diet high in red meat and/or processed meats
  • Physical inactivity
  • Obesity
  • Smoking
  • Heavy alcohol consumption

Non-Life Style Related Risk Factors

  • Age – risk increases at around 50 years of age
  • Individual – history of adenomatous polyps or colorectal cancer
  • Individual – history of Inflamatory Bowel Disease, ulcerative colitis and/or Crohn’s disease
  • Family – relatives with a history of colorectal cancer or adenomatous polyps
  • Heredity – genetic conditions such as: Familial adenomatous polyposis (FAP), Hereditary non-polyposis colon cancer (HNPCC or Lynch syndrome), Turcot syndrome, Peutz-Jeghers syndrome, MUTYH-associated polyposis
  • Racial/Ethnic Background – African Americans are at increased risk (US only) and Jews of Eastern European descent are at increased risk (globally)
  • Type 2 Diabetes


Source: American Cancer Society- Colorectal Cancer Risk Factors


Screening Recommendations Summary

High-Sensitivity fecal occult blood test (FOBT)

  • Every year over age 50 for normal risk patients
  • Screening should begin earlier if patient is at increased risk based on a physician’s assessment

Flexible Sigmoidoscope

  • Every 5 years starting at age 50


  • Every 10 years starting at age 50


Source: Center For Disease Control- Colorectal Cancer Screening Guidelines

Healthcare Provider Cancer Screening Resources

American Cancer Society Physician’s Plan 

How to Increase Colorectal Cancer Screening Rates in Practice: A Primary Care Clinician’s Evidence-Based Toolbox and Guide