Understanding Colorectal Cancer Screening: Methods and Recommendations- Part 1

Colorectal cancer screening saves lives. For average-risk adults, screen ages 50–75; ages 76–85 need individualized decisions; routine screening isn’t advised after 86. High-risk people (family history, IBD, inherited syndromes) should start earlier and screen more often. Home options include faecal occult blood testing: guaiac (gFOBT, diet limits) and faecal immunochemical test (FIT, no diet limits), done annually and lowering mortality 15–33% when repeated every 1–2 years. FIT-DNA combines FIT with stool DNA markers, detecting more cancers/adenomas but with slightly more false positives. Any positive stool test warrants colonoscopy; choose based on risk, preference, and clinician advice.https://corum.com.my/education/

1. UNDERSTANDING COLORECTAL
CANCER SCREENING: METHODS AND
RECOMMENDATIONS

2. SCREENING RECOMMENDATIONS Screening recommended for adults aged 50–75 years
(average risk)
Ages 76–85: individualised screening based on health
and prior results
Ages 86+: routine screening not recommended
High-risk individuals (family history, IBD, inherited
syndromes):
Start earlier
Screen more frequently

3. FAECAL OCCULT BLOOD TEST (FOBT) Detects tiny amounts of blood in stool (hidden bleeding)
Two FDA-approved types:
Recommended annually if used alone
Reduces colorectal cancer deaths by 15–33% when
done every 1–2 years
Guaiac FOBT (gFOBT) – detects heme; requires dietary
restrictions
Faecal Immunochemical Test (FIT/iFOBT) – detects human
haemoglobin; no diet limits

4. STOOL DNA TEST (FIT-DNA) Combines FIT (blood detection) + DNA biomarkers
(from colon cells)
Detects mutations linked to colorectal cancer and
precancerous adenomas
Sample collected at home, mailed to the lab
Positive results → follow-up colonoscopy recommended

5. EFFECTIVENESS AND CONSIDERATIONS FIT-DNA detects more cancers and adenomas than
FIT alone
Slightly higher false-positive rate
Both tests are noninvasive and home-based
Selection depends on patient preference, risk
level, and provider advice

6. https://corum.com.my/education/