Colorectal Cancer Screenings
Colorectal cancer screenings are a covered benefit. The following screenings are covered for those at average risk starting at age 45:
- fecal occult blood test: Once every 12 months
- fecal immunochemical testing (FIT): One stool sample every 12 months
- FIT-DNA: FDA-approved stool DNA tests (e.g. Cologuard™) once every one to three years
- flexible sigmoidoscopy: Once every five years
- computed tomographic colonography: Once every five years
- colonoscopy: Every 10 years
- flexible sigmoidoscopy with annual FIT: Once every 10 years
Note: TRICARE allows for a 30-day grace period prior to due date of the next screening.
According to the American Cancer Society (ACS), for screening, people are considered to be at average risk if they do not have:
- A personal history of colorectal cancer or certain types of polyps;
- A family history of colorectal cancer or advanced adenomatous polyps in at least one first degree relative, or in multiple second degree relatives;
- A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease);
- A confirmed or suspected hereditary colorectal cancer syndrome;
- A personal history of getting radiation to the abdomen (belly) or pelvic area to treat a prior cancer; or
- Signs or symptoms of colorectal cancer.
The American Cancer Society and United States Preventive Services Task Force no longer offer guidelines specifically for people at increased or high risk of colorectal cancer. Providers are encouraged to discuss with beneficiaries who may be at increased or high risk as to whether they need to start colorectal cancer screening before age 45, be screened more often, and/or use personalized testing strategies.
