Table 1

Cancer screening recommendations for those with a family history suggestive of a hereditary colorectal cancer syndrome

SyndromeCancer surveillanceScreening recommendationsConsidered “appropriate” surveillance (for the purpose of this study)
*If polyps are found, assessment of indications for colectomy. If genetic testing is performed and APC gene mutation (−), flexible sigmoidoscopy at age 25.3,7,10
HNPCCColorectalColonoscopy every 1–2 years beginning at age 25Colonoscopy every 1–3 years beginning at age 25
Endometrial (women only)Transvaginal ultrasound ± endometrial biopsy every 1 year beginning at age 25–35Endometrial ultrasound or biopsy every year beginning at age 35
People without polypsColorectalFlexible sigmoidoscopy* every 1 year beginning at age 12Flexible sigmoidoscopy or colonoscopy every 1–3 years
Flexible sigmoidoscopy*
Every 1 years, ages 12–25
Every 2 years, ages 26–35
Every 3 years, ages 36–50
After age 50 resume “average risk” screening
People with polypsUpper tractUpper endoscopy with ampullary biopsy every 6 months to 4 years depending on polyp burdenEGD every 1–5 years
ColorectalSurgical colectomy with continued upper and lower tract surveillance
Subtotal colectomy or total colectomy with ileorectal anastomosisRectal remnantFlexible sigmoidoscopy every 6 months–1 year with polypectomies as neededFlexible sigmoidoscopy every 1 year
Total colectomy with ileoanal anastomosisPouchEndoscopic surveillance of pouch every 3–5 years (increase frequency if polyps are found)Flexible sigmoidoscopy every 3–5 years