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Table 14-3

CRC Screening Recommendations for Adults at Average Risk

U.S. Preventive Task Force—2016American Cancer Society—2018U.S. MTSFa on CRC—2017
Ages for screening
  • Start screening at age 50
  • Stop screening at 75
  • The decision to be screened after 75 to 85 should be made on an individual basis taking into account the patient’s overall health and prior screening history
  • Screening after age 85 is not recommended
  • Start screening at age 45
  • For adults with average CRC risk, in good health, and with a life expectancy of more than 10 years, screening should continue through age 75 years
  • The decision to be screened for patients aged 76 to 85 years should be individualized to patient preference, life expectancy, health status, and prior history of screen
  • Screening after 85 is not recommended
  • Start screening at age 50
  • Limited evidence supports screening African Americans at 45 years
  • Stop screening at age 75 or have <10 years of life expectancy
  • Persons without prior screening should be considered for screening up to age 85, depending on age and comorbidities
  • Colonoscopy and FIT are recommended as the cornerstones of screening regardless of how screening is offered
Highly sensitive gFOBTAnnualAnnualNo recommendation
Highly sensitive FITAnnualAnnualAnnual
FIT fecal DNAEvery 1 or 3 yearsbNo recommendationEvery 3 years
MT-s DNA test Every 3 yearsNo recommendation
FSIGEvery 5 years OR the FSIG and FIT DNA recommendationEvery 5 yearsEvery 5 to 10 years
FSIG and FIT DNAFSIG every 10 years plus FIT every yearNo recommendationNo recommendation
ColonoscopyEvery 10 yearsEvery 10 yearsEvery 10 yearsc
CT colonography (virtual colonoscopy)Every 5 yearsEvery 5 yearsEvery 5 years

a MSTF represents the American College of Gastroenterology, the American Gastroenterological Association, and the American Society for Gastrointestinal Endoscopy.

FITDNA testing suggested by manufacturer.

Colonoscopy offered first, FIT should be offered to patients who decline colonoscopy.

CRC, colorectal cancer; FIT, fecal immunochemical test; FSIG, flexible sigmoidoscopy; gFOBT, guaiac-based fecal occult blood test; MT-s DNA, multi-targeted stool DNA; MTSF, Multi-Society Task Force.