My husband's father was diagnosed with colon cancer at age 62 and passed away a short time later. My husband (47) had a complete colon screening done four years ago and they found polyps. They said he should not be concerned about them and recommended he be retested in about 10 years. With his family history, shouldn't he be retested sooner?

K.S.

Screening for colon cancer is recommended starting at age 50 for people at average risk for colon cancer. This group includes people who do not have a family history of colon cancer and who do not have a medical condition (such as ulcerative colitis) that would predispose them to colon cancer. When someone has a family history of colon cancer, screening is recommended beginning at an age at least 10 years younger than the age when the family member was diagnosed, but no later than age 50. So, since your husband's father was diagnosed at age 62, your husband and his siblings should be screened starting at age 50.

You say your husband was already screened with a colonoscopy when he was in his 40s. The fact that he had polyps is significant. However, it is also important to know how many were present, how big the largest polyp was, and what the pathology report showed. For example, someone with only one or two small polyps (less than 1cm in size) will need less frequent screening than someone who had more numerous and/or larger polyps. Also, the pathological diagnosis is important because some polyps are "hyperplastic," which means they have no malignant potential, while others are "adenomatous," a precancerous state that can lead to colon cancer.

Depending on the specific details of your husband's case, most gastroenterologists would recommend a repeat colonoscopy in a range from a few months (if a large polyp with early cancer was found) to five years (if nothing significant was found). Generally, once they start screening, patients with a family history of colon cancer should be retested about every five years even if no polyps are found.