Colorectal cancer is the second-leading cancer killer in the U.S., killing over 50,000 Americans every year. It is also one of the more treatable cancers and if caught early, can often be cured. Four types of colorectal cancer screening exist: stool testing, flexible sigmoidoscopy, double contrast barium enema, virutal colonoscopy, and colonoscopy. While all four can detect colorectal cancer, colonoscopy is the method of screening preferred by the American College of Gastroenterology. Colonoscopy is recommended every ten years starting at age 50 for people of normal risk. An alternative recommendation is annual stool blood testing combined with flexible sigmoidoscopy every five years. Other options are double contrast barium enema or flexible sigmoidoscopy every five years. A new stool test, the Stool DNA test, is also now available; screening intervals have not yet been determined.

There are many individuals who are at increased risk for developing colorectal cancer, based on personal and family history. Screening recommendations vary significantly depending on particular risk factors. Check with your physician to see if you are at higher risk. Of note, recent updates by the American College of Gastroenterology call for initial screening at age 45 in African Americans of otherwise normal risk. As of October 2008, routine screening is no longer recommended for those greater than 75 years old, but may be advisable in some individuals 76-85 years of age.