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Frequency of colonoscopies with family history of colon cancer

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Timothy C. Hoops, MD
Last Modified: February 24, 2002

Dear OncoLink "Ask The Experts,"

My family has a history of colon cancer. I lost a younger brother to colon cancer when he was 48. I am 52. I had a colonoscopy at age 49 and no polyps were found. I have an older brother who had polyps at age 52 and a younger sister with polyps at 45. My grandfather on my father's side died of colon cancer and my uncle on my father's side has caner of the rectum and is terminal. I filled out the survey.

My question is when should I have my next colonoscopy? My doctor says every five years since I had no polyps. I am concerned since my family has a history of colon cancer that I should test sooner. What do you suggest?  

Timothy C. Hoops, MD, Clinical Assistant Professor of Medicine in the Gastroenterology Division at the University of Pennsylvania and Director of Gastroenterology at Penn Medicine at Radnor, responds:

The frequency of colonoscopies depends on the diagnosis of the family history. In general, with a family history of colon cancer that doesn't look like an inherited syndrome, we recommend a colonoscopy every 5 years, as long as no polyps are found. If there are polyps, the interval will decrease to 3 years, or fewer, depending on the size and histology (what they show under the microscope) of the polyps. If there is a familial syndrome such as hereditary nonpolyposis colorectal cancer (HNPCC), the recommendation is a colonoscopy every 2 years. Your family history is suggestive for HNPCC, but doesn't meet all criteria. In particular, your father didn't have colon cancer. Talk to your gastroenterologist to see if the possible diagnosis of HNPCC might change his recommendation.