Colorectal Cancer Screening

Screen men and women > 50 years of age for colorectal cancer (CRC).

Potenial screening options are numerous.  However, within the Indian Health Service setting, access to care and cost constraints may limit provider options.  As a result, the Indian Health Service recommends the following:

1. Renewed emphasis on CRC screening.

2. Improved patient education about CRC screening.

3. Fecal occult blood testing (3 samples gathered at home) every year if possible;
               every 2 years at a minimum.

4. Appropriate follow-up for positive FOBT results.

5. Additional screening options if available:

                a.    Flexible sigmoidoscopy within the last 5 years
                            b.    Annual FOBT plus flexible sigmoidoscopy every 5 years
                            c.    Double contrast enema every 5 years
                            d.    Colonoscopy within the last 10 years

If the patient is at risk for earlier onset CRC (e.g., first degree relative with onset of CRC before age 50), screening should begin earlier and more frequently.