Colon Cancer Screening Guidelines from the NCCN
by Dr. C.H. Weaver M.D. (08/2018)
These guidelines are designed to diagnose cancers in early, highly treatable stages or detect precancerous conditions before they progress, adhering to them is the first step toward a successful outcome for both men and women.
The National Comprehensive Cancer Network (NCCN), an alliance of 21 of the world’s leading oncology centers, establishes guidelines for the screening and treatment of cancer; it updates the screening procedures annually or as needed to capture the latest data. The following are the NCCN’s current screening guidelines for colon cancer.
Individuals who are 50 or older have different screening options for colorectal cancer, although a colonoscopy is the preferred method. There are five screening schedules based on the type of screening test as well as initial findings that indicate that no cancer or other serious conditions exist. If abnormal results are produced by any of these screening methods, a colonoscopy should follow.
- Colonoscopy every 10 years. A colonoscopy includes the evaluation of the entire large intestine through a lighted camera that is inserted through the rectum. The image of the large intestine is shown on a screen so the physician can identify any abnormal-looking areas. A biopsy )sample of tissue) may be obtained during the colonoscopy to determine if cancer or other diseases exist.
- Flexible sigmoidoscopy every five years. A sigmoidoscopy includes the evaluation of the lower portion of the large intestine. A lighted camera is inserted through the rectum so the physician can visually examine the area for abnormalities.
- Fecal occult blood test (FOBT) or fecal immunochemical test (FIT) every year. FOBT and FIT tests can detect small amounts of blood or cellular changes in the stool that may be indicative of colorectal cancer. FOBT may be performed at home with a kit that is provided to patients.
- FOBT or FIT test every year plus flexible sigmoidoscopy every five years. This combination method is preferred to either yearly FOBT/FIT or flexible sigmoidoscopy every five years.
- Double-contrast barium enema every five years. An enema including barium contrast is given prior to an X-ray. The barium contrast allows the physician to visualize the colon on X-ray and detect any abnormalities.
Individuals with the following high-risk factors should discuss their own health history and family health history with their physician to determine their optimal individual screening schedule.
- A strong family history of colorectal cancer or colorectal polyps (growths that are not cancerous but are often considered a precursor to cancer) including first-degree relatives (parent, sibling, or child) younger than 60 or two first-degree relatives of any age
- A history of colorectal cancer or colorectal polyps
- A history of chronic inflammatory bowel disease
- A family history of hereditary colorectal cancer syndrome (familial adenomatous polyposis or hereditary nonpolyposis colon cancer)
It is important that everyone undergo screening for cancer, including colon cancer, to ensure optimal chances of early detection or prevention and, ultimately, long-term survival. If family health history is accessible, understanding this link is important so that discussions with healthcare providers can be held and appropriate assessments in terms of the hereditary risk of developing certain cancer can be made. Screening schedules will be revised to reflect each individual’s risks.
About the National Comprehensive Cancer Network
The National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 27 leading cancer centers devoted to patient care, research, and education, is dedicated to improving the quality, effectiveness, and efficiency of cancer care so that patients can live better lives. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers.
The NCCN Member Institutions are: Fred & Pamela Buffett Cancer Center, Omaha, NE; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Dana-Farber/Brigham and Women’s Cancer Center | Massachusetts General Hospital Cancer Center, Boston, MA; Duke Cancer Institute, Durham, NC; Fox Chase Cancer Center, Philadelphia, PA; Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; Mayo Clinic Cancer Center, Phoenix/Scottsdale, AZ, Jacksonville, FL, and Rochester, MN; Memorial Sloan Kettering Cancer Center, New York, NY; Moffitt Cancer Center, Tampa, FL; The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute, Columbus, OH; Roswell Park Comprehensive Cancer Center, Buffalo, NY; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO; St. Jude Children’s Research Hospital/The University of Tennessee Health Science Center, Memphis, TN; Stanford Cancer Institute, Stanford, CA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; UC San Diego Moores Cancer Center, La Jolla, CA; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; University of Colorado Cancer Center, Aurora, CO; University of Michigan Rogel Cancer Center, Ann Arbor, MI; The University of Texas MD Anderson Cancer Center, Houston, TX; University of Wisconsin Carbone Cancer Center, Madison, WI; Vanderbilt-Ingram Cancer Center, Nashville, TN; and Yale Cancer Center/Smilow Cancer Hospital, New Haven, CT.