CRC screening

(JAMA 2021;325:1978)

• Colonoscopy gold standard.

• Other options:

  • FOBT/FIT yearly
  • flex sig q5y or flex sig q10y + FIT every year,
  • fecal DNA testing (eg, Cologuard) q3y or
  • CT colonography q5y

• Start screening in average risk Pts at ↣ age 45 (typically q10y unless abnl found)

• If ⊕ FHx, start age 40, or 10 y before age of dx in youngest family member, repeat q5y

• If no adenomas are found

  • on the first surveillance colonoscopy, the next surveillance colonoscopy should be performed in 10 years
  • no increased risk for colorectal cancer

• If a low-risk adenoma is → detected,

  • the next surveillance colonoscopy should be performed at ↣ tive years.

• If a high-risk adenoma is → detected,

  • the next surveillance colonoscopy should be performed in three years.