Most cases of colorectal cancers occur between age 60 to 79. Individuals who are not at known increased risk for colon cancer should start surveillance with digital rectal exam and fecal occult blood test at age 40 and colonoscopy at age 50. However, patients with known increased risk for hereditary colon cancer are usually diagnosed at young age.  These patients should be surveyed regularly for malignant growth at young age, even if there are no symptoms. 

The most widely used screening test for colorectal cancer is colonoscopy. The scope, attached to a thin fiber optic cable, is inserted to the rectum and extended up to the colon. Physicians can visualize the inside of the colon, take pictures and/or biopsy any suspicious growth with this procedure. Patients with known genetic defect for FAP or Gardner’s Syndrome should start colonoscopy screening at age 15.

Patients with HNPCC usually are not at risk of developing multiple colon polyps, but cancerous changes for these patients are also best diagnosed with colonoscopy. Individuals of families known to be affected by HNPCC gene should start colonoscopy at age 20 to 25 because colon cancer may develop in these patients at a young age. Since patients affected by HNPCC gene are also at higher risk of other types of cancer, especially cancer of Gastrointestinal tract and uterine cancer, regular surveillance for these types of malignancies is also recommended.

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For more information on colorectal cancer, please visit the  Colorectal Cancer Home Page.