Colon Cancer Screening Guidelines

Medicare Guide to Preventative Services – April 2007
Colorectal Cancer Screening Tests


• Fecal Occult Blood (FOBT)
• Flexible Sigmoidoscopy
• Colonoscopy
• Barium Enema

Unless the words “High Risk” are specified, all of the following guidelines are for patients who are at a normal risk for developing colorectal cancer:

High Risk Factors

A sibling, parent, or child had an adenomatous polyp or colon cancer
• Family history of adenomatous polyposis or hereditary colorectal cancer
A personal history of adenomatous polyps, colorectal cancer, or Inflammatory Bowel Disease (IBD)

A patient is at “high risk” if he has any of these above risk factors.

After age 50, all annual time periods listed below are given a 30 day grace period; whereby the physician may commence Colorectal Cancer Screening up to 30 days earlier than specified:

Medicare Covered Fecal Occult Blood (FOBT)
Annually if age 50

Medicare Covered Flexible Sigmoidoscopy
• Beginning age 50, then once every 4 years

Medicare Covered Colonoscopy
• Once every 2 years for a patient with high risk factors (without regard to age)
• Beginning age 50, then once every 10 years

• Must be at least 4 years after a Flexible Sigmoidoscopy.

Medicare Covered Barium Enema

• As an alternative to Colonoscopy of Flexible Sigmoidoscopy
• Once every 2 years for a patient with high risk factors (without regard to age)
• Beginning age 50, then once every 4 years
• Preferably a double contrast Barium EnemaType your paragraph here.