Table 1.

Screening guidelines for first-degree relatives of patients with advanced adenoma

	Diagnosis	Early screening guideline
USMSTF	AA or CRC in 1 FDR < 60 yr of age or 2 FDRs (any age)	Colonoscopy every 5 yr beginning 10 yr before the age at diagnosis or at the age of 40 yr, whichever is earlier.
	AA or CRC in 1 FDR ≥60 yr of age	Begin screening at 40 yr of age. Options for screening and intervals are the same as those for average-risk persons.

According to the USMSTF, when FDRs have documented advanced serrated lesions (SSPs ≥1 cm, SSP with cytologic dysplasia, or a TSA ≥ 1 cm*), there is no clear evidence as to how to proceed (unless the relative meets criteria for serrated polyposis syndrome). They recommend screening FDRs of persons with advanced serrated lesions similar to screening of FDRs of persons with advanced conventional adenomas (see ref. 1).

^*Please note a TSA of any size is considered advanced for the proband surveillance (see ref. 11).

AA, advanced adenoma; CRC, colorectal cancer; FDR, first-degree relative; SSP, sessile serrated polyp; TSA, traditional serrated adenoma; USMSTF, United Society Multi-Society Task Force.