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At or slightly above average risk
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·No personal history of bowel cancer
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FOBT every second year from the age of 50 years.
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·Either no close relatives with bowel cancer or one first-degree or second-degree relative with bowel cancer diagnosed at age 55 years or older.
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Consider sigmoidoscopy (preferably flexible) every five years.
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Moderately increased risk
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·One first-degree relative diagnosed before the age of 55 years (without potentially high-risk features listed below), or
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Colonoscopy every five years starting at age 50, or at an age 10 years younger than the age of first diagnosis of CRC in the family, whichever comes first.
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·Two first-degree relatives or one first- and one second-degree relative(s) on the same side of the family (without potentially high-risk features listed below).
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Potentially high risk
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·Three or more first-degree or a combination of first-degree and second-degree relatives on the same side of the family diagnosed with bowel cancer (suspected HNPCC*), or
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Dependent on presence and type of familial cancer.
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At least colonoscopy every 5 years.
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Age of screening commencement dependent on familial colorectal cancer syndrome identified***
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·Two or more first-degree or second-degree relatives on the same side of the family diagnosed with bowel cancer, including any of the following high-risk features:
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- bowel cancer before the age of 50 years
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- multiple bowel cancers in the one person
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- at least one relative with cancer of the endometrium, ovary, stomach, small bowel, renal pelvis, ureter, biliary tract or brain
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- at least one first-degree relative with a large number of adenomas throughout the large bowel (suspected FAP)**
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- somebody in the family in whom the presence of a high-risk mutation in the adenomatous polyposis coli (APC) gene or one of the mismatch repair (MMR) genes has been identified.
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