Colorectal Cancer Screening: Latest Guidelines

Screening Modalities

Colonoscopy remains gold standard, detecting and preventing cancer. FIT testing is noninvasive but requires annual testing. CT colonography and capsule endoscopy are alternatives when colonoscopy incomplete.

When to Start

Average-risk individuals should begin at 45. African Americans and those with family history may start earlier. Patients with IBD or genetic syndromes need personalized surveillance plans.

Polyp Management

Adenomatous polyps require surveillance based on size, number, and histology. Sessile serrated lesions demand particular attention due to malignant potential. Complete resection is critical.

Quality Metrics

Adequate bowel prep, cecal intubation rates, and adenoma detection rates (>25% in men, >15% in women) are key quality indicators. These significantly impact screening effectiveness.

Emerging Technologies

AI-assisted polyp detection, blood-based tests, and improved stool DNA tests are expanding options. However, colonoscopy remains cornerstone for prevention through polypectomy.