Colorectal Cancer, Adenocarcinoma of the Colon, Rectal Cancer, Colon Cancer, and Colon Polyps

Assessment and Plan: Colorectal Cancer, Adenocarcinoma of the Colon, Rectal Cancer, Colon Cancer, Colon Polyps

• Colorectal cancer screening:

• Ages 50-75: The U.S. Preventive Services Task Force recommends screening for colorectal cancer for all individuals 50-75 years old with either fecal occult blood testing every year, fecal occult blood testing every 3 years plus sigmoidoscopy every 5 years, or screening colonoscopy every 10 years (26).

• Ages 76-85: The routine screening for colorectal cancer among adults age 76-85 years is not recommended by the U.S. Preventive Services Task Force unless not previously screened and if benefit outweighs the risk. The rationale not to screen after age 75 is the fact that the benefit is not seen until 7 years later in clinical trials. (26)

• Ages 85 years and older: The U.S. Preventive Services Task Force recommends against screening for colorectal cancer since risk of mortality outweighs the benefits (26).

• Recommendations by other organizations for colorectal cancer screening:

• Since 2008, the American College of Radiology, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American Cancer Society have collectively favored testing with annual guaiac-based fecal occult blood test with 2 to 3 stool samples, annual fecal immunochemical test, or annual stool DNA test and if positive, perform flexible sigmoidoscopy (with insertion to 40 cm/splenic flexure every 5 years), colonoscopy every 10 years, double contrast barium enema every 5 years, and computed tomography colonography every 5 years (27).

• According to the U.S. Preventive Services Task Force (USPSTF), the American College of Physicians, American Academy of Family Physicians, American College of Preventive Medicine, and Centers for Disease Control and Prevention have similar recommendations or have endorsed the USPSTF recommendation (26).