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Screening Guidelines for GI Cancers

The only gastrointestinal, or GI, cancer for which regular screening is recommended in the United States is colorectal cancer because one in eight people in the general population will get colorectal cancer, and it is preventable in nearly all cases. Research has shown that regular screening reduces colorectal cancer deaths because it allows the asymptomatic precancerous polyps to be found and removed before they can become cancer.

Screening procedures are available for other GI-related cancers as well, including esophageal, liver, and stomach, but screening may only be recommended for those who have a high risk for developing one of these cancers. Screening for pancreatic cancer is recommended only in a very select group, as currently available screening procedures have shown a greater potential for harm than benefit.

Colorectal Cancer Screening Guidelines
For most people, screening for colorectal cancer is recommended starting at age 50, and at least every 10 years thereafter. For some populations with a higher risk of developing colorectal cancer, such as those with a family history of colorectal cancer, and people with certain genetic conditions, the recommended age to begin screening may be younger than 50. For individuals of African American descent, colorectal cancer has been shown to present at a slightly earlier age, so screening is recommended starting at age 45. Adults over 75 may or may not continue to be screened, depending on their overall health and prior screening history.

The recommended frequency of screening depends on the screening method:

  • Colonoscopy: recommended every 10 years, or more often if precancerous polyps are found
  • CT colonography, also called virtual colonoscopy: recommended every five years
  • Flexible sigmoidoscopy: recommended every five years
  • Flexible sigmoidoscopy with fecal immunochemical test (FIT): flexible sigmoidoscopy recommended every 10 years plus FIT every year
  • Fecal occult blood tests, including guaiac fecal occult blood test (gFOBT) and FIT: recommended every year