COLONOSCOPY SCREENING

** Risk Category	Definition	Age to Start Screening	Recommended Screening
Average	Age 50 or older and no other risk factors	50 years	Colonoscopy every 10 years
Moderately Increased	One First Degree Relative (Immediate family member - mother, father, brother, sister) with colorectal cancer*	40 years	Colonoscopy at least every 10 years.
*must have a letter from physician stating family history
High	Two or more First Degree Relatives (Immediate family member - mother, father, brother, sister) with colorectal cancer*	40 years or 10 years younger than age diagnosis of the youngest affected relative, whichever is earlier.	Colonoscopy every 3-5 years
*must have a letter from physician stating family history

*A family history of pre-cancerous polyps predicts increased risk also. Screening recommendations for persons with a family history of polyps should be individualized, but screening is often similar to that used in persons with a family history of colorectal cancer.
**Recommendations made by the American College of Gastroenterolgy.

	Fecal Occult Blood Test - testing allowed one time per year, when ordered by a licensed physician. This benefit available to all members. This may be performed through any licensed physician. For a complete list of approved Frontpath providers; please refer to your Frontpath directory.
	Flexible Sigmoidoscopy - testing allowed once every four years for average risk patients. Reference below for description of Average Risk. This test may be performed through any licensed physician and facility. For a complete list of approved Frontpath providers and facilities, please refer to your Frontpath directory.
	Colonoscopy - (Moderately Increased Risk) - testing allowed once every ten years with screening beginning at age 40. Reference below for description of Moderately Increased Risk. This test must be performed through a Preferred Provider contracted through the Health Plan. Must contact the Plan Office for prior authorization.
	Colonoscopy (High-Risk) - testing allowed once every 3-5 years with screening beginning at or 10 years younger than age at diagnosis of the youngest affected relative, whichever is earlier. Reference below for description of High-Risk. This test must be performed through a Preferred Provider contracted through the Health Plan. Must contact the Plan Office for prior authorization.