Skip to Content

Colorectal Screening: High Risk

If you are at high risk for colorectal cancer, you are at higher risk of getting the disease than someone at increased risk. MD Anderson recommends different screening schedules for each type of high risk group.  These guidelines are for men and women without any colorectal cancer symptoms. If you have any symptoms, you should see your health care provider as soon as possible.

Personal history of Familial Adenomatous Polyposis or suspected of having Familial Adenomatous Polyposis without having undergone genetic testing, you should:

  • Get a flexible sigmoidoscopy every year beginning at age 10 to 12 to determine if you are developing polyps
  • Talk to a genetic counselor and consider genetic testing. If a genetic test is positive, talk to your health care provider about when surgery to remove the colon (colectomy) should be considered.

Personal history of Hereditary Nonpolyposis Colorectal Cancer or you have a family history of Hereditary Nonpolyposis Colorectal Cancer, you should:

  • Get a colonoscopy every one to two years beginning at age 20 to 25, or 10 years before the youngest case in the immediate family (parent, brother, sister, son or daughter). For example, if the youngest case in your family was someone age 23, you should begin testing at age 13.
  • Talk to a genetic counselor about genetic testing if there is a family history of Hereditary Nonpolyposis Colorectal Cancer

Crohn’s disease (inflammatory bowel disease), you should:

  • Get a colonoscopy every one to two years with biopsies to find dysplasia (abnormal cells)
  • Begin  colonoscopy 12 to 15 years after colitis begins in the left side of the colon

Chronic ulcerative colitis (inflammatory bowel disease), you should:

  • Get a colonoscopy every one to two years with biopsies to find dysplasia (abnormal cells)
  • Begin colonoscopy eight years after colitis begins in the entire colon

MD Anderson does not recommend colorectal cancer screening for men and women age 85 or older. Screening for adults ages 76 to 85 should be considered on an individual basis by a health care provider.

These screening guidelines apply to men and women who are expected to live for at least another 10 years. The guidelines are not for men and women who have a health condition that would make it hard for a health care provider to find and treat colorectal cancer.

Request an Appointment

For Physicians

Use our flowchart to determine cancer screening recommendations for patients. 


© 2014 The University of Texas MD Anderson Cancer Center