How does colonoscopy compare with fecal occult blood testing as a screening tool for colon cancer?
The USPSTF review found both screening strategies cost-effective (<$30,000 per additional life-year gained) compared to no screening. FOBT had a cost per life-year saved of $5691 to $17,805 compared with $9038 to $22,012 for colonoscopy performed every 10 years.5
Recommendations from others
The USPSTF found strong evidence to recommend screening in this age group beginning at age 50 but found insufficient evidence to determine a preferred strategy. The evidence reviewed here does not apply to patients at higher risk for colorectal cancer based on personal history, family history or symptoms.
The TABLE details the American Cancer Society and the US Multisociety Task Force on Colorectal Cancer’s 2003 updates recommending options for screening average-risk individuals for colorectal cancer beginning at age 50.6,7
TABLE
Recommended options for screening average-risk individuals for colorectal cancer
| TEST OR PROCEDURE | FREQUENCY* |
|---|---|
| 3-card fecal occult blood test | Annually |
| Flexible sigmoidoscopy | Every 5 years |
| Double-contrast barium enema | Every 5 years |
| Colonoscopy | Every 10 years |
| *Beginning at age 50 for men and women. | |
