Your doctor can help you determine which screening is right for you. 

Colorectal Cancer Screening

Screening Saves Lives!

Colorectal cancer screening saves lives in two important ways:

  1. By finding and removing precancerous polyps before they become cancerous
  2. By detecting the cancer early when it is most treatable

Both men and women should undergo testing for the disease beginning at age 50. People with a high risk for colorectal cancer and those with a family history should talk with their doctor about being screened at an earlier age.

In March 2014, American Cancer Society released data showing colon cancer incidence rates have dropped 30% in the U.S. in the last 10 years among adults ages 50 and older due to the widespread uptake of colonoscopy, with the largest decrease occurring in those ages 65 and older. 

On this page, you'll find information about the different types of tests to screen for colorectal cancer and precancerous polyps.

female endoscopist

Screening tests for colorectal cancer

Screening is done on individuals who do not necessarily have any signs or symptoms that may indicate cancer. If symptoms exist, then diagnostic workups are done rather than screening. These are the tests recommended for colorectal cancer screening and some general pros and cons for each:

What Screening Is For Me?

  • Colonoscopy

  • Fecal immunochemical testing (FIT)

  • FIT-Fecal DNA Test

  • Stool blood test (fecal occult blood test--FOBT)

  • Flexible sigmoidoscopy (flex-sig)

  • Virtual colonoscopy (CT Colonography)


screening poster


FIT image

Colorectal Cancer Screening Tests Covered by Medicare

Colorectal Cancer Screening Tests Covered by Medicare In 2000, Medicare started paying for colonoscopy for people age 50 and older. Prior to 2000, Medicare only covered the exam for people at high risk or with symptoms. People on Medicare now have more choices for screening tests. For people on Medicare, this is what is covered:

* Colonoscopy every two years for those at high risk

* Colonoscopy once every 10 years – or 4 years after a flex-sig test -- for those age 50 and over at average risk

* Stool blood test (FIT or fecal occult blood test) each year for those 50 and over * Stool DNA test (FIT-Fecal DNA test) every three years for individuals ages 50-85 who do not have colorectal cancer symptoms nor an increased risk of colorectal cancer

* Flex-sig every four years -- but not within 10 years of a prior colonoscopy -- for those age 50 and over at average risk

* Barium enema with air contrast instead, once every two years for high-risk individuals and every four years for those at average risk, if a doctor believes that it is as good as or better than flex-sig or colonoscopy

* Virtual colonoscopy is not covered by Medicare as initial screening tests

Colonoscopy is the most commonly utilized screening test for colon cancer since it has a high yield of detecting precancerous polyps and is able to remove them.

The Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act, passed in 2010, waives the coinsurance and deductible for many colorectal cancer screening tests, including colonoscopy, sigmoidoscopy and fecal occult blood testing (FOBT). Colonoscopy is a unique screening test because gastroenterologists are able to remove precancerous polyps during the screening procedure. Under Medicare billing rules, removal of any polyp reclassifies the screening colonoscopy as a therapeutic procedure for which patients will receive a coinsurance bill. This is often unexpected by patients who may be under the impression that deductible or coinsurance charges were waived.

There are ongoing efforts to correct this problem. ASGE, along with the American Cancer Society Cancer Action Network (ACS CAN), the American College of Gastroenterology, and the American Gastroenterological Association (AGA), are advocating that Congress fix this "cost-sharing" problem, which continues to cause confusion for patients and providers. The Removing Barriers to Colorectal Cancer Screening Act of 2017 introduced in February 2017 by Rep. Charlie Dent, R-PA, waives the coinsurance for a screening colonoscopy, regardless of whether a polyp or lesion is found. Congressman Dent's bill applies the same rational policy to beneficiary coinsurance. The expectation is that this will eventually be corrected.

Coverage for Screening Tests With Private Insurance

In February 2013, the federal government issued an important clarification on preventive screening benefits under the Affordable Care Act. Patients with private insurance will no longer be liable for cost sharing when a precancerous colorectal polyp is removed during screening colonoscopy. This ensures colorectal cancer screening is available to privately insured patients at no additional cost, as intended by the new health care law. Patients with Medicare coverage must still pay a coinsurance when a polyp is removed as a result of the screening colonoscopy. Click here for the guidance language provided by the administration. Patients with private insurance should check with their individual providers to learn the details of their coverage and ask about the Affordable Care Act.

For questions about this Web site, contact info@asge.org. For questions specifically related to your health and getting screened for colorectal cancer, contact your doctor, or click here to find a doctor in your area.