Table 1.
Comparative study of screening guidelines in selected countries
| Country | Number of risk group | Criteria | Subgroup | Screening method | Age of screening | Interval screening | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Canada | 2 groups | Symptomatic/ Asymptomatic regardless of age but positive family history |
HNPCC | Colonoscopy | Begin colonoscopy at age 20 or 10 younger than the earliest diagnosis of colorectal cancer in the family | 1-2 years | |||||
| FAP | Sigmoidoscopy | Begin at age 10-12 years | Annually | ||||||||
| AFAP | Colonoscopy | Begin at age 16-18 years | Annually | ||||||||
| One first degree relatives with cancer or adenomatous polyp at age >60 or Two or more first degree relatives with polyp or colon cancer at any age | Colonoscopy | Begin colonoscopy at age 40 or 10 younger than the earliest diagnosis of colorectal cancer in the family | Every five years | ||||||||
| One first degree relatives with cancer or adenomatous polyp at age <60 or Two or more second degree relatives with polyp or colon cancer at any age | Colonoscopy | Begin at age 40 years | - | ||||||||
| One second degree relative or third degree relative affected | Colonoscopy | Begin at age 50 years | - | ||||||||
| Polyps found at colonoscopy/ 1-2 tubular adenomas<1cm | Colonoscopy | - | In five years | ||||||||
| Polyps found at colonoscopy/>2 adenomas | Colonoscopy | - | In 3 years | ||||||||
| Ulcerative colitis or Crohn’s colitis | Colonoscopy | - | At age 8-10 years | ||||||||
| Australia | 3 groups | Symptoms of CRC | Abdominal pain/Unexplained tiredness/weight loss/ Lump/mass in tummy (abdomen)/Rectal bleeding/A persistent (beyond 2 week) change in bowel habit | Colonoscopy | - | Within 30 day | |||||
| Personal history of CRC and adenoma | Bowel cancer, Polyps. IBD such as Ulcerative colitis or Crohn’s colitis | Colonoscopy | - | Within 30 day | |||||||
| Family history of CRC and adenoma | One first degree and ≥ 2 first or second degree relatives on the same side of the family OR One first degree and ≥ 1 first or second degree relatives on the same side of the family diagnosed with: - multiple bowel cancers in one person - bowel cancer < 50 years - other HPNCC related cancers |
Colonoscopy | from age 25 or 5 years earlier than the youngest relative diagnosed, whichever comes first. |
every 1-2 years | |||||||
| Relatives diagnosed with FAP | flexible sigmoidoscopy or colonoscopy | From age 12-15 or from diagnosis. | Annually | ||||||||
| Relatives diagnosed with Lynch Syndrome (HNPCC) | Colonoscopy | from age 25 or 5 years earlier than the youngest relative diagnosed, whichever comes first. |
every 1-2 years | ||||||||
| One first degree relative diagnosed with bowel cancer < 55 years OR Two first or second degree relatives on the same side of the family diagnosed with bowel cancer at any age. |
Colonoscopy | from age 50 every 5 years or 10 years earlier than the youngest relative diagnosed with bowel cancer, whichever comes first. |
every 5 years | ||||||||
| One first degree relative diagnosed with bowel cancer ≥ 55 years | FOBT | - | - | ||||||||
| High risk | HNPCC | Colonoscopy | Age 20 to 25 years, or 10 years before the youngest case in the immediate family | every 1 to 2 years | |||||||
| FAP | flexible sigmoidoscopy or colonoscopy | Age 10 to 12 | Annually | ||||||||
| IBD | Colonoscopy | 8 years after the onset of pancolitis (involvement of entire large intestine), or 12-15 years after the onset of left-sided colitis | every 1 to 2 years | ||||||||
| People with small rectal hyperplastic polyps | Colonoscopy | Starting at age 50 | every 10 years | ||||||||
| People with 1 or 2 small (less than 1 cm) tubular adenomas with low-grade dysplasia | Colonoscopy | 5 to 10 years after the polyps are removed | Time between tests should be based on other factors such as prior colonoscopy findings, family history, and patient and doctor preferences. | ||||||||
| USA | 3 groups | Increased risk (Personal history polyp and CRC/ family history polyp and CRC) |
|||||||||
| People with 3 to 10 adenomas, or a large (at least 1 cm) adenoma, or any adenomas with high-grade dysplasia or villous features | Colonoscopy | 3 years after the polyps are removed | every 5 years | ||||||||
| People with more than 10 adenomas on a single exam | Colonoscopy | 3 years after the polyps are removed | every 3 years | ||||||||
| People with sessile adenomas that are removed in pieces | Colonoscopy | 2 to 6 months after adenoma removal | doctor’s judgment | ||||||||
| People diagnosed with colon or rectal cancer | Colonoscopy | At time of colorectal surgery, or can be 3 to 6 months later if person doesn’t have cancer spread that can’t be removed | If the tumor presses on the colon/rectum and prevents colonoscopy, CT colonoscopy (with IV contrast) or DCBE may be done to look at the rest of the colon. | ||||||||
| People who have had colon or rectal cancer removed by surgery | Colonoscopy | Colonoscopy one year after resection, | if colonoscopy at one year is negative, repeats at three years and then every 3-5 years if normal | ||||||||
| Colorectal cancer or adenomatous polyps in any first- degree relative before age 60, or in 2 or more first-degree relatives at any age (if not a hereditary syndrome). | Colonoscopy | Age 40, or 10 years before the youngest case in the immediate family, whichever is earlier | every 5 years | ||||||||
| Colorectal cancer or adenomatous polyps in any first- degree relative aged 60 or older, or in at least 2 second- degree relatives at any age | Colonoscopy | Age 40 years | every 10 years | ||||||||
| Average risk | Asymptomatic, Negative personal and family history of CRC and adenoma, age 40-57 | Colonoscopy | - | every 10 years | |||||||