Colorectal Cancer

Summary of recommendations for clinicians and policy-makers

The CTFPHC will continue to carefully monitor the scientific developments in screening for colorectal cancer and will report back to Canadians within 5 years with an update of the 2016 guidelines.

These recommendations apply to adults aged ≥50 years who are not at high risk for colorectal cancer (CRC). They do not apply to those with previous CRC or polyps, inflammatory bowel disease, signs or symptoms of CRC, history of CRC in one or more first degree relatives, or adults with hereditary syndromes predisposing to CRC (e.g. familial adenomatous polyposis, Lynch Syndrome).

Recommendations

• We recommend screening adults aged 60 to 74 for CRC with FOBT (either gFOBT or FIT) every two years OR flexible sigmoidoscopy every 10 years.
  (Strong recommendation; moderate quality evidence)
• We recommend screening adults aged 50 to 59 for CRC with FOBT (either gFOBT or FIT) every two years OR flexible sigmoidoscopy every 10 years.
  (Weak recommendation; moderate quality evidence)
• We recommend not screening adults aged 75 years and over for CRC.
  (Weak recommendation; low quality evidence)
• We recommend not using colonoscopy as a screening test for CRC.
  (Weak recommendation; low quality evidence)

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Additional Documents

• Clinician Summary
• Protocol (pdf)
• Systematic Review (pdf)
• Excluded Studies (pdf)
• Evaluating the Cancer Risk Management Model (pdf)
• Additional Resources
• CMAJ Author Podcast
• Guideline Presentation