Colorectal Cancer Exams
TRICARE covers the following based on your risk for colon cancer.
|Your Risk Level||TRICARE Covers:|
|Average Risk||Beginning at age 50, through age 85:
|Increased Risk||Risk Factor||What's Covered|
|One or more first degree relatives diagnosed with sporadic colorectal cancer or an adenomatous polyp before the age of 60 or in two or more first degree relatives at any age.
||Optical colonoscopy every 3-5 years. This begins at age 40 or 10 years earlier than the youngest affected relative, whichever is earlier.|
|One or more first degree relatives diagnosed with sporadic colorectal cancer or an adenomatous polyp at age 60 or older, or two second-degree relatives diagnosed with colon cancer.
||Flexible sigmoidoscopy (once every 5 years) or optical colonoscopy (once every 10 years). This begins at age 40 or 10 years earlier than the youngest affected relative, whichever is earlier.
|High Risk||Risk Factor||What's Covered|
|Known or suspected Familial Adenomatous Polyposis (FAP)||Flexible sigmoidoscopy annually beginning at age 10 to 12.|
|Family history of Hereditary Non-Polyposis Colorectal Cancer (HNPCC) syndrome
||Optical colonoscopy once every 1-2 years. This begins at age 20 to 25, or 10 years younger than the earliest age of diagnosis of colorectal cancer, whichever is earlier.
|Inflammatory Bowel Disease (IBD), Chronic Ulcerative Colitis (CUC), or Crohn's disease||Your cancer risk begins to be significant eight years after the onset of pancolitis or 10 to 12 years after the onset of left-sided colitis. If you have these risk factors, then you should get an optical colonoscopy every one to two years with biopsies for dysplasia.|
This list of covered services is not all inclusive. TRICARE covers services that are medically necessaryClick to closeTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. and considered proven. There are special rules or limits on certain services, and some services are excluded.
Last Updated 3/8/2019