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Checkup
Calendar
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| Guidelines for Screening and Surveillance
for the Early Detection of Colorectal Polyps and Cancer, by Risk
Category. |
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| Recommendations for Average Risk Adults 50+
(i.e., Men and women without moderate and high risk characteristics as
described in the next section) (age 45+ to be considered for African
Americans). |
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| Fecal Occult Blood Test x 3 (FOBT) |
Annual, beginning at age 50 |
| with Flexible Sigmoidoscopy/Barium Enema |
Every 5 years |
| Preferred Method is: |
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| Colonoscopy |
Every 10 years beginning at age 50 (age 45 for
African Americans). |
| Alternative is : Virtual CT
colonography (intervals not yet determined). Risk of radiation
exposure. Not a covered service. |
| Colonoscopy is a covered service under
Medicare and many private health insurance plans. |
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| Guidelines for Moderate risk adults
ages 50 and older: |
| One first degree relative with colorectal
cancer diagnosed at age 60 or older. Start screening at age
40 then every 10 years.
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| Personal History of single, small <1cm adenomatous polyp |
Total colonoscopy followup at 3-5 years. |
| Personal History of large >1cm or multiple adenomatous polyps
of any size. |
Total colonoscopy followup within 3 years of initial
polyp removal
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| Personal history of curative-intent resection of
colorectal cancer resection. |
Total colonoscopy within 1 year of resection then at 3
years postop.
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| Colorectal cancer in other relatives (not first degree)
Family history of pre-cancerous
polyps should be individualized. |
Follow recommendations for average risk individuals.
Consider guidelines similar to family history of colon cancer. |
HIGH RISK
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| Colorectal cancer, or adenomatous polyps, in first
degree relative younger than 60, or in 2+ first degree relatives of
any ages. First degree= mother/father/brother/sister/child |
Total colonoscopy every 3-5 years. beginning at age 40
or ten years prior to the age of diagnosis of the youngest
affected relative, whichever is earlier. No alternative is
considered adequate. |
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| Family history of Familial Adenomatous Polyposis (FAP) |
Early surveillance with endoscopy, counseling to
consider genetic testing, and referral for specialty care at puberty. |
| Family history of Hereditary Nonpolyposis Cancer
Syndromes (HNPCC) |
Colonoscopy and counseling to consider genetic testing
at age 21 |
| Inflammatory Bowel Disease (Crohn's Disease/Ulcerative
Colitis). |
Colonoscopy with biopsies for dysplasia 7-10 years after
the start of pancolitis; 12-15 years after the start of left-sided
colitis. Followup colonoscopy with biopsies every 1-2
years. |
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