Table 2 Recommendations for colorectal cancer screening in individuals at increased risk*

First-degree relative with colorectal cancer or adenomatous polyp(s): same as for average risk individual, but begin at age 40

Family history of FAP

Genetic counseling (consider genetic testing)

Annual flexible sigmoidoscopy beginning at puberty if gene carrier or indeterminate

Family history of HNPCC

Genetic counseling (consider genetic testing)

Colonoscopy every 1–2 years beginning at age 20–30, annually beginning at age 40

History of inflammatory bowel disease

Consider colonoscopy surveillance for dysplasia every 1–2 years beginning after 8 years of disease for pancolitis and after 15 years of disease for left-sided colitis