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Colorectal cancer Prevention

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Prevention

Screening

Intestinal cancer almost always develops from benign tumours inside the intestine over the course of several years. Annual screening with occult blood tests such as Roche Diagnostics' hemo FEC^® should be performed annually from the age of 40 to 50 years, since patients can usually be cured if the tumour is detected early. This simple action could save your patient's life!

Please note that screening recommendations and guidelines may differ from country to country. The following statements are based on guidelines prepared by a panel convened by the U.S. Agency for Health Care Policy and Research updated in 2003.

Asymptomatic persons at average risk

Men and women at average risk should be offered one of the following options beginning at the age of 50:

• Fecal occult blood testing: Annual fecal occult blood testing is the most commonly performed screening test for colorectal cancer. It has demonstrated on the basis of high-quality evidence from randomized clinical trials to reduce risk of death from colorectal cancer. The test should include an analysis of three serially obtained samples of stool - OR -
• Sigmoidoscopy: every 5 years - OR -
• Combined fecal occult-blood testing and flexible sigmoidoscopy every 5 years - OR -
• Colonoscopy every 10 years

Persons with family history of colorectal carcinoma or polyps

Degree of relativity	No. of affected family members	Age	Recommendation
First-degree relative	Any	≤ 60 yr	Colonoscopy every 5 years beginning at age 40 or 10 years before the age of the youngest affected relative
First-degree relative	2	Any	Colonoscopy every 5 years beginning at age 40 or 10 years before the age of the youngest affected relative
First-degree relative	Any	> 60 yr	Same options as average risk but starting at age 40 years (only in the case of colorectal cancer)
Second-degree relative	2	Any	Same options as average risk but starting at age 40 years
Second-or third-degree relative	1	Any	Same options as average risk

Inherited syndromes of colorectal cancer

Patients with FAP should be referred to genetic testing or annual screening by sigmoidoscopy beginning at age 10 - 12 years. Patients with HNPCC should be referred to genetic testing, or to colonoscopy every 1- 2 years beginning at age 20 - 25 years, or 10 years younger than youngest age of colorectal cancer diagnosis in family.

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