For U.S. individuals over the age of 50, the yearly incidence of Colorectal Cancer is 1.8/1000.  This means that over 200 MCI patients will come down with Colon Cancer each year.   Although this is considered one of the most preventable cancers and the advantages of early detection and treatment are well documented, too few people are participating in screening:  only 39% of colon cancer is currently detected by screening.

Due to cost and patient reluctance to undergo colonoscopy greater emphasis should be placed on occult blood screening.  New immunochemical occult blood tests have been reported to detect up to 90% of colon cancers. 

1. All MCI patients over the age of 50 should be offered Colorectal Cancer Screening as part of their routine preventive health exams. 
2. For all average risk asymptomatic patients over age 50, MCI recommends:
   • Fecal Occult Blood Testing Yearly 
     • preferably immunochemical type – one sample per year

              And / Or

• Colonoscopy every 10 years

Acceptable Colorectal screening alternatives, for average risk, asymptomatic  patients, are:

*American Cancer Society prefers this option compared to either alone
**Doing one of the above tests excludes the others until the time interval is completed except for FOBT which can be done yearly.

Variation from this guideline is always acceptable, if in the opinion of the attending physician, individual circumstances require it