What about my family?

By Annie Nelson, RN, MSN, CNL Apr 28, 2017

In my navigation practice, one of the most common questions I hear from individuals is, “When do my family members need to start getting checked for colorectal cancer?” Well, the answer depends upon a few things.

First, how old were you when you were diagnosed with colorectal cancer (CRC)? According to the American Cancer Society, if you were LESS THAN 60 years old when diagnosed, any of your first-degree relatives (parents, siblings or children) need to have a colonoscopy starting at age 40 or 10 years before the youngest family member was diagnosed, whichever is sooner. The same guideline applies if a person has two first-degree relatives with CRC.

If you were diagnosed at age 60 or OLDER, your first-degree relatives still need to start screening at age 40. This same guideline applies if you have two second-degree relatives (such as a cousin, grandparent, aunt, uncle, niece or nephew) with CRC. However, screening options expand to include:

  • Colonoscopy: a screening test that inserts a thin, flexible tube, called a colonscope, with a light and camera into the rectum to look at the colon for ulcers, polyps, tumors, inflammation and bleeding
  • CT colonography: a special X-ray examining the large intestine for cancer and polyps.
  • Double-contrast barium enema: a contrast radiography where an X-ray test of the large intestine (colon and rectum) is taken after liquid containing barium is placed in the rectum to clearly show the colon structure
  • Flexible sigmoidoscopy: a procedure examining the inside of the colon
  • Guaiac-based fecal occult blood test (gFOBT) and fecal immunohistochemistry test (FIT): tests searching for hidden blood in the stool
  • Stool DNA test: a noninvasive test identifying DNA changes in the cells of a stool sample

The answer to this question changes if you’re diagnosed with a genetic condition increasing your risk of developing CRC. If you were diagnosed with a genetic condition such as familial adenomatous polyposis (FAP) or Lynch syndrome, please speak to your health care provider and/or a genetic counselor about your family’s specific risks and best surveillance strategy. The best protection is early detection!


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