Clinical Preventive Service Recommendation

Colorectal Cancer

Colorectal Cancer, Adults

The AAFP recommends screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonscopy, in adults, beginning at age 50 years and continuing until age 75 years. The risk and benefits of these screening methods vary. (2008)

(Grade: A recommendation)
Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm(www.uspreventiveservicestaskforce.org)
Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm(www.uspreventiveservicestaskforce.org)

Colorectal Cancer, Adults

The AAFP recommends against routine screening for colorectal cancer in adults age 76 to 85 years. There may be considerations that support colorectal caner screening in an individual patient. (2008)

(Grade: C recommendation)
Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm(www.uspreventiveservicestaskforce.org)
Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm(www.uspreventiveservicestaskforce.org)

Colorectal Cancer, Adults

The AAFP recommends against screening for colorectal cancer in adults older than age 85 years. (2008)

(Grade: D recommendation)
Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm(www.uspreventiveservicestaskforce.org)
Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm(www.uspreventiveservicestaskforce.org)

Colorectal Cancer, Chemo Prevention

The AAFP recommends against the routine use of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) to prevent colorectal cancer in individuals at average risk for colorectal cancer. (2008)

(Grade: C recommendation)
Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm(www.uspreventiveservicestaskforce.org)
Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsasco.htm(www.uspreventiveservicestaskforce.org)

Colorectal Cancer, Chemo Prevention, DNA Testing

The AAFP concludes that the evidence is insufficient to assess the benefits and harms of computed tomographic colongraphy and fecal DNA testing as screening modalities for colorectal cancer. (2008)

(Grade: I recommendation)
Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm(www.uspreventiveservicestaskforce.org)
Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm(www.uspreventiveservicestaskforce.org)

Colorectal Cancer, Genomic Testing

The AAFP recommends offering genetic testing for Lynch syndrome to patients newly diagnosed with colorectal cancer to reduce morbidity and mortality in relatives. Genetic testing should be offer to first degree relatives of those found to have Lynch syndrome, and those positive for Lynch syndrome should be offered earlier and more frequent screening for colorectal cancer. (2012)

Clinical considerations: http://www.egappreviews.org/docs/EGAPPWG-LynchRec.pdf (www.egappreviews.org)


These recommendations are provided only as assistance for physicians making clinical decisions regarding the care of their patients. As such, they cannot substitute for the individual judgment brought to each clinical situation by the patient's family physician. As with all clinical reference resources, they reflect the best understanding of the science of medicine at the time of publication, but they should be used with the clear understanding that continued research may result in new knowledge and recommendations. These recommendations are only one element in the complex process of improving the health of America. To be effective, the recommendations must be implemented.