Associate Director & Unit Head, Surgical Oncology, Max Hospital, Gurgaon
Part 9 of 10 in Diagnosis and Management of Rectum Cancer
Colorectal Cancer Screening: Who Should Get Tested and When
September 5, 2026
Screening for colorectal cancer is intended for healthy individuals with no symptoms, not only for patients who are already unwell.
The Recommended Schedule
From the age of forty, a fecal occult, or fecal immunochemical, blood test once a year, combined with a colonoscopy once every ten years, is the recommended screening approach.
A Test That Works Even With Limited Resources
The fecal occult blood test can be performed even at a primary or general hospital level. It is not highly specific and can miss some cases, but it remains a genuinely useful, low-cost way to flag patients who need further evaluation, especially where colonoscopy requires referral to a larger centre.
← When Is Chemotherapy or Radiotherapy Needed Before Rectal Cancer Surgery? | Series index | Referring a Colorectal Cancer Patient for Treatment in India →
This article is based on a Jivo Masterclass session conducted by Dr. Kaushal Kishore Yadav, Associate Director & Unit Head, Surgical Oncology, Max Hospital, Gurgaon, India. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass: Dr. Kaushal Kishore Yadav taught doctors across Africa on June 15, 2025.
FROM THE LIVE Q&A
Moderator
Explained what an online OPD is, for doctors wanting to bring a relevant patient to Dr. Yadav.
Dr. Kaushal Kishore Yadav
When a Jivo doctor partner has a relevant patient, they collect the case details and share the information with the Jivo team in advance. The patient is invited to the partner doctor's own clinic, where Dr. Yadav then joins the consultation by video call, so the consultation is guided jointly by doctors in both India and Africa.
Book a Consultation with Dr. Kaushal Kishore Yadav
Book on WhatsAppOr message us on WhatsApp: +91 98182 98669
Frequently Asked Questions
Relayed a French-speaking participant's request: will the session recording and presentation be shared afterward?▼
Yes. The webinar recording link will be shared with participants, and Dr. Yadav's presentation, in English, will also be shared.
Many doctors at a first or second-level hospital see colorectal cancer patients they cannot treat, and even the most advanced hospital available to them locally cannot treat these cases either. What should a doctor in this position do?▼
Nothing stops a doctor from referring the complex case to an Indian oncologist in parallel, so the patient has a second treatment pathway. Many patients from African countries who present to India face the same underlying problem: the evaluation, diagnosis and route to treatment usually takes a long time in the home country, and by the time they present to us the disease is already at an advanced stage, sometimes stage four with limited options.
Confirmed that no CT scan is available for him to order at his level-one facility. What workup can still be done in that situation?▼
For a patient with a change in bowel habit and an otherwise unexplained low haemoglobin level, send a colonoscopy first. Do a colonoscopy and CT scan whenever there is real suspicion, and don't delay. Even at a primary level, a fecal occult blood test can be done; it is not very specific and may miss some cases, but it can still help.
Shared what is available at his own facility: a fecal occult (or immunochemical) blood test can be sent as a general surgeon at his primary or general hospital, but what happens beyond that?▼
That test is the only early reading that can be done at that level; genetic-level investigation is not available in that setup. For colonoscopy, the patient has to go to a tertiary hospital and bring the results back. At least the fecal occult blood test is available, and even though it is not very specific, it can help catch some cases.
Asked whether sphincter-preserving surgery (intersphincteric resection) can really be done even for a distal rectal cancer, one lying very low in the rectum.▼
Yes. Rectal cancer spreads upward along its natural embryological lymphatic supply rather than downward, so staying strictly within that anatomical plane allows the tumour to be removed completely, following guidelines that show even a minimal distal margin of one centimetre is adequate. An intraoperative frozen section can confirm all microscopic cancer cells have been cleared, and this makes it possible to go between the internal and external anal sphincter even for the lowest-lying tumours, preserving a normal passage instead of requiring a permanent stoma.
At what age should colorectal cancer screening begin?▼
From age forty, with a fecal occult blood test once a year and a colonoscopy once every ten years.
Is colorectal cancer screening only for people with symptoms?▼
No, screening is intended for healthy individuals with no symptoms, to catch the disease before it becomes symptomatic.
Can colorectal cancer screening be done where colonoscopy isn't available?▼
Yes, a fecal occult blood test can be done at a primary or general hospital and, while not highly specific, helps flag patients who need referral for colonoscopy.
In This Series: Diagnosis and Management of Rectum Cancer
- 1.Diagnosis and Management of Rectum Cancer
- 2.Warning Signs and Risk Factors for Colorectal Cancer
- 3.The Diagnostic Workup for Colon and Rectum Cancer: Tests, Scans and Staging
- 4.Sphincter-Preserving Surgery for Low Rectal Cancer
- 5.Complete Mesocolic Excision with Central Vascular Ligation for Colon Cancer
- 6.Open, Laparoscopic and Robotic Surgery for Colon and Rectum Cancer
- 7.Managing Stage 4 Colorectal Cancer: Liver and Peritoneal Metastases
- 8.When Is Chemotherapy or Radiotherapy Needed Before Rectal Cancer Surgery?
- 9.Colorectal Cancer Screening: Who Should Get Tested and When
- 10.Referring a Colorectal Cancer Patient for Treatment in India