¹Risk factors indicating need for earlier/more frequent screening: personal history of CRC or adenomatous polyps or hepatoblastoma, CRC or polyps in a first-degree relative age. (Ann Intern Med. 1998;128(1):900; Am J Gastroenterol. 2009;104:739; N Engl J Med. 1994;331(25):1669; 1995;332(13):861). Additional high-risk group: history of ≥30 Gy radiation to whole abdomen; all upper abdominal fields; pelvic, thoracic, lumbar, or sacral spine. Begin monitoring 10 y after radiation or at age 35 y, whichever occurs last (http://www.survivorshipguidelines.org). Screening colonoscopy in those age ≥ 80 y results in only 15% of the expected gain in life expectancy seen in younger patients. (JAMA. 2006;295:2357)

¹A positive result on an FOBT should be followed by colonoscopy. An alternative is flexible sigmoidoscopy and air-contrast barium enema.

²FOBT should be performed on 2 samples from 3 consecutive specimens obtained at home. A single stool guaiac during annual physical examination is not adequate.

³USPSTF did not find direct evidence that a screening colonoscopy is effective in reducing CRC mortality rates.

⁴Use the guaiac-based test with dietary restriction, or an immunochemical test without dietary restriction. Two samples from each of 3 consecutive stools should be examined without rehydration. Rehydration increases the false-positive rate.

⁵Population-based retrospective analysis: risk of developing CRC remains decreased for >10 y following negative colonoscopy findings. (JAMA. 2006;295:2366)

¹First-degree relative diagnosed prior to age 60 or advanced adenoma in ≥2 first-degree relatives at any age.

¹High-risk groups include those with gastric adenomas, pernicious anemia, gastric intestinal metaplasia, Lynch syndrome, familial adenomatous polyposis, and family history of gastric cancer.

¹HBV prevalence ≥ 2% in Africa, Asia, South Pacific, Middle East (except Cyprus and Israel), Eastern Europe (except Hungary), Malta, Spain, indigenous populations of Greenland, Alaska natives, indigenous populations of Canada, Caribbean, Guatemala, Honduras, and South America. HBV prevalence ≥ 8% in Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Congo, Côte d’Ivoire, Djibouti, Equatorial Guinea, Gabon, Gambia, Ghana, Guinea, Liberia, Malawi, Mali, Mauritania, Mozambique, Namibia, Niger, Nigeria, Senegal, Sierra Leone, Somalia, South Sudan, Sudan, Swaziland, Togo, Uganda, Zimbabwe, Haiti, Kiribati, Nauru, Niue, Papua New Guinea, Solomon Islands, Tonga, Vanuatu, Kyrgyzstan, Laos, Vietnam, Mongolia, Yemen.

²Risk factors for HCV infection: injection drug use, intranasal illicit drug use, men who have sex with men, long-term hemodialysis patients, percutaneous/parenteral exposures in an unregulated setting; health care providers and public safety workers after needlestick, sharps, or mucosal exposures to HCV-infected blood; children born to HCV-infected women, history of incarceration, prior recipients of blood transfusion(s) or organ transplant, HIV infection, sexually active persons about to start preexposure prophylaxis for HIV, unexplained chronic liver disease and/or chronic hepatitis, solid organ donors and transplant recipients.