o*Colonoscopy – highest efficacy for precancer/cancer
o Fecal immunochemical test (FIT) – 50% sensitivity,
noninvasive, every 3 years
o Fecal occult blood – 50% sensitivity, noninvasive,
every 3 years
o CT colongraphy – ↑radiation risk, ↓bowel
perforation risk, every 5 years
o Flexible sigmoidoscopy – if palpable mass felt in rectum,
may still need colonoscopy, every 5 years
o Pillcam - after incomplete colonoscopy with lack
of obstruction
o Tumor markers – 46% reliability particularly
carcinoembryonic antigen (CEA). Are valuable after CRC identification to identify subequent relapse
Septin9 Serum assay – 48% sensitivity to CRC
only, no detection of precancerous tissue
COLONOSCOPY SCREENINGS
o Highest efficacy for precancer/cancer
o Recommended screening at age 50 and every 10 years thereafter
o Unless positive family history, inflammatory bowel disease - age 40
o Polyp biopsy pathology – often adenocarcinoma
