Table 1 Risk stratification of patients for CRC
Risk stratification | Included participants | Age of onset & intervalsa for CRC screening | Method of choice for CRC screening |
|---|---|---|---|
Low-risk group | People under 50Â years old without alarm signs, positive family history for colorectal cancer, positive family history for other genetic syndromes related to colorectal cancer, personal history of colorectal cancer, and personal history of colorectal polyps | No need for CRC screening | No need for CRC screening |
Intermediate-risk group | People 50–75 years old without alarm signs, positive family history for colorectal cancer, positive family history for other genetic syndromes related to colorectal cancer, personal history of colorectal cancer, and personal history of colorectal polyps | 50–75 yearsb | FIT |
High-risk group | Patients with positive family history for genetic syndromes related to colorectal cancer | Based on genetic syndrome | Colonoscopy |
Positive family history for advanced adenoma/colorectal cancer in one first degree relative less than 60 years old or ≥ 2 first degree relatives at any age | At 40 years or 10 years prior to the youngest age at which a person is involved and then every 5 years | ||
Positive family history for colorectal cancer or advanced adenoma in one first degree relatives at age ≥ 60 years old | At age 40 and then every 10 years | ||
Positive personal history for inflammatory bowel diseases | 8Â years from onset of disease | ||
Positive personal history for colorectal cancer | At years 1 and 3 after surgery then every 5Â years | ||
Positive personal history for advanced adenomas/high-risk sessile serrated polyps/hyperplastic polyps | 3Â years later | ||
Positive personal history for low-risk adenomas/sessile serrated polyps/hyperplastic polyps | 7–10 years later for adenomas, 5–10 years later for sessile serrated polyps, 10 years later for hyperplastic polyps | ||
Positive personal history for more than 10 adenomas/20 hyperplastic polyps | 1Â year later | ||
Positive personal history of rectal bleeding accompanied by age ≥ 50 years old or abdominal pain, change in bowel habit, weight loss, anemia of iron deficiency | Immediately | ||
Positive personal history for unexplained abdominal pain/weight loss/anemia of iron deficiency/change in bowel habit | Immediately | ||
Positive personal history for abdominal or rectal mass | Immediately |