Table 3:  Comparison of U.S. Colorectal Cancer Screening Guidelines for Average Risk Individuals.




Joint Guideline:1


US Multi-Society Task Force2

American College of Radiology

March 2008

American College of Gastroenterology3

December 2008




Draft Recommendation

Age to Start Screening

50 years

50 years (45 years for black persons)

50 years

Age to Stop Screening

Stop when curative therapy is not an option


Not addressed

Individualize decision between age 76 and 85 and stop screening after age 85

Colorectal Cancer Detection Tests



Annual FIT is preferred CRC detection test for those who decline colonoscopy or other CRC prevention test. Annual Hemoccult SENSA is an alternative CRC detection test.


Multi-target Stool DNA test

Every 3 years

Every 3 years as alternative to FIT for CRC detection

Insufficient evidence to recommend

Colorectal Cancer Prevention Tests


Every 5 years

Replaced by CT colonography

Not Addressed

CT Colonography

Every 5 years

Every 5 years as alternative to colonoscopy for CRC prevention

Insufficient evidence to recommend

Flexible Sigmoidoscopy

Every 5 years with or without annual gFOBT or FIT

Every 5 to 10 years as alternative to colonoscopy for CRC prevention

Every 10 years together with annual FIT


Every 10 years

Preferred test every 10 years for CRC prevention

Every 10 years


1Any one of the recommended tests is acceptable, but prevention of colorectal cancer is the greater priority

2US Multi-Society Task Force includes the American College of Gastroenterology, American Gastroenterological Association, and the American Society for Gastrointestinal Endoscopy

3Preferred strategy of CRC preventive tests over CRC detection tests, with colonoscopy as preferred test

4Any one of the recommended tests is adequate

ACS: American Cancer Society; USPSTF:  United States Preventive Services Task Force; gFOBT:  high sensitivity guaiac fecal occult blood test;

FIT:  fecal immunochemical test; CRC: colorectal cancer; DNA: deoxyribonucleic acid; DCBE:  double-contrast barium enema; CT: computed tomography