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HomeMedical Information CancerWhy, How and How Often: Colorectal Cancer Screening Explained

Why, How and How Often: Colorectal Cancer Screening Explained

By: Medix Team

Screening is essential for colorectal cancer, but one shouldn’t get carried away. Best practice is following internationally accepted screening guidelines.

Colorectal cancer is one of the most commonly diagnosed cancers worldwide; third most common and fourth leading cause of death worldwide. 1,361,000 new cases of colorectal cancer were found in the year 2012. So how does the cancer develop? Small growths, called polyps can grow inside the colon. If left alone, 15% of these polyps may undergo a change that makes them malignant, leading to colorectal cancer and the aforementioned results.


Given this information, what can be done? The best way to deal with this form of cancer is to prevent it in the first place by identifying polyps before they turn cancerous, or finding the cancer early and treating it.


Starting with how: the gold standard for screening are colonoscopies. The advantage of this method is high accuracy, the disadvantage is that it is invasive, and can cause serious complications such as bleeding, and in some cases a torn colon. A second test is a stool test, which checks for cancer biomarkers. The advantage of this method is that it is not invasive, the disadvantage is that it does not identify polyps, only cancer stage growths.  


However, knowing which tests are appropriate isn’t enough. People are at different risk of getting colon cancer; the higher the individual risk, the more often screening is required. Lower risk individuals, do not need to undergo as much screening because aside from being expensive, it can lead to serious complications. 


What are the risks? Extensive research has been carried out on this exact question and two categories of risk factors exist; Modifiable risk factors and non-modifiable risk factors. A diet comprised of heavy consumption of red and processed meats, obesity and smoking are all risk factors connected to lifestyle choices made by the individual, making them modifiable. On the other hand, age, sex and genetic mutations, family history and previous polyps are non-modifiable factors and so must be taken as a given. Based on a combination of these factors, one can be either be at low risk, moderate risk or high risk.


Internationally recognized guidelines recommend the following: For low risk patients, colonoscopy screening should start at age fifty, with a colonoscopy done every ten years. For screening with stool tests, one every 1-2 years is recommended. For moderate risk patients, colonoscopy should be carried out once every three years, and for high risk patients, one every 1-3 years based on the specific circumstances. Screening should start at 50 years of age, unless a first degree family member (parent or sibling) had colorectal cancer, in which case screening should start ten years before the age the family member was diagnosed.


These guidelines have been proven to lead to the best results, effectively reducing cancer rates and mortality. Being aware of your options is important as well as the guidelines for proper use of these tests.  


Risk Profile

Starting Age

How Often?

Low Risk


Every 10 Years

Family History

Ten years before the age of the family member when diagnosed

According to risk profiles

Moderate Risk

50/According to Family History

Every 3 Years

High Risk

50/According to Family History

Every 1- 3 Years

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