Who should be screened for colorectal cancer

Screening for colorectal cancer is recommended for all Australians in the average risk population from age 50, every 2 years until age 75.1

Measures to increase uptake of the screening program could include recall and reminders. GP recommendation for screening might make people more likely to return a test.1

Participation in screening is lower in Aboriginal and Torres Strait Islander peoples, and there is a lower survival rate.1

Table: RACGP – Colorectal cancer detection by risk1

Average or slightly increased risk

Moderately increased risk

High risk

Who

Asymptomatic people with:

  • no personal history of bowel cancer, colorectal adenomas or ulcerative colitis and no confirmed family history of colorectal cancer
    OR
  • one first- or second-degree relative with colorectal cancer diagnosed at age 55 years or older

1–2% of the population.

Asymptomatic people with:

  • one first-degree relative with colorectal cancer diagnosed before age 55 years
    OR
  • two first-degree or one first- and one second-degree relative/s on the same side of the family with colorectal cancer diagnosed at any age (without potentially high-risk features)

<1% of the population. (Relative risk of ~4–20)

For specific risk populations and interventions please refer to the RACGP Red Book.

What to do
  • FOBT
  • Colonoscopy
  • Sigmoidoscopy plus double-contrast barium enema or CT colonography (performed by an experienced operator) acceptable if colonoscopy is contraindicated
For specific risk populations and interventions please refer to the RACGP Red Book.
How often
  • Every 2 years from age 50 years
  • Every 5 years from age 50 years, or at an age 10 years younger than the age of first diagnosis of colorectal cancer in the family, whichever comes first
  • Consider offering FOBT in intervening years
For specific risk populations and interventions please refer to the RACGP Red Book.

 Table and related information taken from the RACGP Red Book.

For more information

References
  1. Guidelines for preventive activities in general practice (The Red Book) 8th Edition. Melbourne: The Royal Australian College of General Practitioners, 2012. http://www.racgp.org.au/your-practice/guidelines/redbook/ (accessed 8 January 2013).