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Colorectal Cancer Screening Guidelines for 2022

Colonoscopy Recommendations

Colorectal cancer, a name for cancers that start in the colon or rectum, is the second leading cause of cancer-related deaths in adults. This year, it’s estimated that nearly 150,000 men and women will be newly diagnosed.

The overall diagnosis rate has decreased since the 1980s, but the rates in younger patients have been steadily increasing. To improve the chances of finding colorectal cancer in earlier stages and in a younger population, the recommended screening age was recently lowered to 45.

Why is Screening for Colorectal Cancer so Important?

Colorectal cancer can often be caught early or before it even starts. Screening looks for polyps in the colon or traces of blood in the stool that might indicate cancer. Polyps are unexpected growths of tissue in the colon. Most are harmless, but some polyps can develop into cancer over time. A polyp can take 10-15 years to grow into cancer. Early screening can catch them before they have a chance to develop into cancer. Polyps are often small and often don’t cause symptoms.

2022 Screening Recommendations

New screening guidelines recommend anyone with an average risk of developing colorectal cancer should be screened starting at age 45.

Screening guidelines by age are:

  • 45-75 — colonoscopy every 10 years for average-risk patients
  • 76-85 — selective testing based on individual factors, such as overall health, life expectancy, and previous screening history
  • 85 and up — not recommended

Your doctor may recommend screening younger than 45 if you have increased risk factors.

What is an “Average” Risk of Colorectal Cancer?

Your risk level is considered average if you have:

  • No history of colorectal cancer or polyps
  • No family history of colorectal cancer
  • No history of Crohn’s disease or ulcerative colitis
  • No history of or suspected hereditary cancer syndrome (familial adenomatous polyposis or Lynch syndrome
  • No history of previous cancer treatment in the abdomen or pelvic area

What is an “Increased” Risk of Colorectal Cancer?

Your doctor may recommend more frequent or earlier testing if you have an increased risk of developing colorectal cancer. You may have an increased risk if:

  • You or a close relative had polyps or cancer previously
  • You have ulcerative colitis or Crohn’s disease
  • Your family has a history of a genetic syndrome like Lynch syndrome or familial adenomatous polyposis (FAP)
  • You’ve had cancer with radiation to the abdomen or pelvic area

Is a Colonoscopy the Only Option?

There are several different types of screening. Some can be done at home, while others require an office or hospital visit and sedation. Stool-based tests are lab tests that check your stool for signs there might be cancer. They are usually repeated every one to three years. Tests other than colonoscopies have a higher likelihood of false positives and false negatives. Also, in the event a test is abnormal, a follow-up diagnostic colonoscopy may be necessary.

Colonoscopy is considered the gold standard for colorectal cancer screening.

You and your doctor will decide which method is best for you, depending on personal circumstances, like:

  • Health status
  • Screening history
  • Family history
  • Preferences

Talk to your doctor about the right time for you to get screened. Finding and removing polyps early can mean the difference between preventing cancer and treating it.

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