**8. Conclusions and recommendations**

Although there are several methods available for CRC screening, none is optimal. Patients at average risk for CRC should begin screening at age 50 with either annual FOBT, flexible sigmoidoscopy every 5 years or colonoscopy every 10 years. Evidence does not show any strategy as optimal, so clinicians should discuss the advantages and disadvantages of the various screening techniques with patients. Patients with a family history of CRC or adenomas or a personal history of high-risk polyps or inflammatory bowel disease should begin screening earlier (figure 7). Routine screening in persons older than 75 years of age is not recommended. Life expectancy, rather than age alone, should guide decisions about when to stop CRC screening.
