Table 4.

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	Documented AA in >1 FDR (any age)a	Age 40–50, or 10 y younger than age of diagnosis of FDRb	Colonoscopy every 5–10 y or FIT every 1–2 y
		GRADE: conditional recommendation, very-low-quality evidencec
US-MSTF3	Documented AA in 1 FDR <60 y or in 2 FDRs with AA (any age)	Age 40, or 10 y younger than age of diagnosis of FDRb	Colonoscopyd every 5 y
		Weak recommendation, low-quality evidence
	AA in 1 FDR ≥60 y	Age 40	Same as for average-risk persons (colonoscopy every 10 y or FIT annually)
		Weak recommendation, low-quality evidence
	Documented ASL in >1 FDR	According to recommendations for family history of documented AA
		Weak recommendation, very-low-quality evidence
NCCN5	Confirmed AA or ASL in 1 FDR (any age)	Age 40, or at age of diagnosis of AA in FDRb	Colonoscopy every 5–10 y
		Category 2A recommendation

Abbreviation: ASL, advanced serrated lesions.

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

^bWhichever is earlier.

^cConsensus group was not able to make a recommendation (neither for or against) the use of colonoscopy as the preferred screening test over no screening or all other screening modalities.

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