Table 3.

Colorectal cancer screening guidelines and strength of recommendation for individuals with a family history of colorectal cancer

	Family History	Age to Initiate Screening	Preferred Test, Interval
Banff Consensus Statement (CAG/AGA)4	CRC in 1 FDRa	Age 40–50, or 10 y younger than age of diagnosis of FDRb	Colonoscopy preferred every 5–10 y or FITc every 1–2 y
		GRADE: conditional recommendation, very-low-quality evidence
	CRC in ≥2 FDR	Age 40, or 10 y younger than age of diagnosis of FDRb	Colonoscopyd every 5 y
		GRADE: conditional recommendation, very-low-quality evidence
US-MSTF3	CRC in 1 FDR <60 y or in 2 FDRs with CRC (any age)	Age 40, or 10 y younger than age of diagnosis of FDRb	Colonoscopye every 5 y
		Weak recommendation, low-quality evidence
	CRC in 1 FDR ≥60 y	Age 40	Same as for average-risk persons (colonoscopy every 10 y or FIT annually)
		Weak recommendation, very-low-quality evidence
NCCN5	≥1 FDR with CRC at any age	Age 40, or 10 y younger than age of diagnosis of FDR	Colonoscopy every 5 y
		Category 2A recommendation

^aRecommend screening over no screening (GRADE: strong recommendation, moderate-quality evidence).

^bWhichever is earlier.

^cFIT as second-line screening option (GRADE: conditional recommendation, moderate-quality evidence).

^dColonoscopy as the preferred screening test over no screening or all other modalities (GRADE: strong recommendation, very-low-quality evidence).

^ePersons should be offered annual FIT if they decline colonoscopy (GRADE: strong recommendation, moderate-quality evidence).